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Keytruda/chemo combo recommended for first-line lung cancer via Cancer Drugs Fund

Published on 08/08/19 at 10:37am

MSD’s Keytruda (pembrolizumab) has secured recommendation from NICE for inclusion on the Cancer Drugs Fund (CDF) in combination with chemotherapy in the first-line treatment of untreated metastatic squamous non-small cell lung cancer (NSCLC), it has emerged.

The final appraisal determination marks the first for a immunotherapy/chemotherapy combo in this indication regardless of PD-L1 expression. The ruling stipulates that the combo should only be used in patients who have stopped at two years of uninterrupted treatment with Keytruda, or earlier in the event of disease progression.

The decision was reached based on Phase 3 data which showed that the combo imrpved overall survival by 15.9 months compared to 11.3 months and reduced the risk of death by 36% when compared to chemotherapy alone. Additionally, the combo extended progression free survival by 44%, while the objective response rate was 57.9% compared to chemo alone.

“It is of great and lasting importance that we will now be able to offer patients with advanced squamous non-small cell lung cancer (NSCLC), the combination of chemotherapy plus pembrolizumab as a first line treatment option,” remarked Professor Gary Middleton, Professor of Medical Oncology at the University of Birmingham. “Progress in the first line treatment of this cancer has been frustratingly slow and, until this time, there has not been any agent which, when added to chemotherapy, provides really robust and clinically meaningful benefits over chemotherapy alone. The addition of pembrolizumab significantly improves overall survival compared to chemotherapy alone and, importantly, across all strata of tumour cell PD-L1 expression. The combination of pembrolizumab and chemotherapy in eligible patients with advanced squamous NSCLC should now become the first line standard of care and the benchmark for future first line studies in this disease.”

Louise Houson, UK Managing Director at MSD, said: “We are pleased that following this approval the majority of lung cancer patients now have access to some form of immunotherapy, including those patients with particularly hard to treat forms of this disease. We have, as ever, worked collaboratively with NHS England and NICE to ensure the value of pembrolizumab in combination with chemotherapy is recognised. Enabling access to the first immunotherapy/chemotherapy combination for this form of lung cancer in the first line setting will make a real difference to patients. We hope that this continues as we look to bring more indications to market in the near future.”

Matt Fellows


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