Home Australia A breakthrough drug can cut the chances of lung cancer coming back by a third when used alongside chemotherapy and surgery – so why have NHS bosses rejected it?

A breakthrough drug can cut the chances of lung cancer coming back by a third when used alongside chemotherapy and surgery – so why have NHS bosses rejected it?

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NHS bosses have been urged to reverse their decision to reject a breakthrough lung cancer drug that reduces the chance of the disease returning by a third (file photo)

NHS bosses have been urged to reverse their decision to reject a breakthrough lung cancer drug that cuts the chances of the disease returning by a third.

Durvalumab has been shown in trials to be effective in curing patients with the most common form of lung cancer when combined in the early stages of the disease with chemotherapy and surgery.

Last month, US health authorities approved a £70,000-a-year infusion for this group of patients, benefiting thousands of people.

And it is already offered on the NHS for those with advanced lung cancer that has spread throughout the body and who have not responded to other treatments.

However, experts were shocked when, two weeks ago, the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), concluded that it would not follow the US lead and approve durvalumab for early-stage lung cancer.

NHS bosses have been urged to reverse their decision to reject a breakthrough lung cancer drug that reduces the chance of the disease returning by a third (file photo)

He said it was unclear how much the drug was more effective than existing treatments.

But experts disagree and say NICE should reconsider its position, allowing around 1,500 patients to benefit each year.

Dr John Conibear, clinical oncologist at Barts Cancer Centre, said: ‘Durvalumab is a really important advance for a group of patients who urgently need more options.

‘The risk of cancer coming back in these patients is high even after surgery and we know that giving durvalumab before and after surgery significantly increases the time patients remain cancer-free.

“It is disappointing that NICE has decided not to approve it and I hope it will reconsider its decision.”

Every ten minutes someone in the UK is diagnosed with lung cancer (around 50,000 new patients each year) and only a quarter survive five years.

Around 35,000 people die from it each year, making it the leading cause of cancer deaths in the UK. The most common form of the disease is non-small cell lung cancer, which accounts for around 80 per cent of new cases.

This cancer is predominantly triggered by smoking and is most common in people between 60 and 70 years of age.

Durvalumab has been shown in trials to be effective in curing patients with the most common form of lung cancer when combined in the early stages of the disease with chemotherapy and surgery (stock photo0

Durvalumab has been shown in trials to be effective in curing patients with the most common form of lung cancer when combined in the early stages of the disease with chemotherapy and surgery (stock photo0

When it is detected before it has spread outside the lungs, it is treated with a combination of chemotherapy, an immune-boosting drug called nivolumab and then surgery to remove the tumors.

However, more than half of patients will suffer from the disease again within five years.

When this happens, it becomes more resistant to conventional treatments and most patients do not live more than three years after this occurs.

Durvalumab is a PD-L1 inhibitor, which means it helps the body detect cancer cells that are hiding from the immune system, allowing it to attack and destroy them.

It is given in four monthly infusions along with chemotherapy before surgery and then on its own after the procedure for another year.

In 2023, data from an international trial with 800 participants concluded there was a 32 percent reduction over four years in the risk of the cancer returning or patients dying compared with chemotherapy alone.

However, NICE says that because the trial does not directly compare the effectiveness of durvalumab with the existing drug nivolumab, it cannot say with certainty whether the drug was worth its high price.

Nivolumab, first approved for lung cancer in 2017, costs around £68,000 per treatment.

NICE also expressed concern that a recent study found one in five patients suffered side effects including nausea, constipation, fatigue and muscle pain.

Similar side effects are seen in about one in ten patients receiving nivolumab.

Durvalumab is a PD-L1 inhibitor, meaning it helps the body detect cancer cells hiding from the immune system, allowing it to attack and destroy them (file photo)

Durvalumab is a PD-L1 inhibitor, meaning it helps the body detect cancer cells hiding from the immune system, allowing it to attack and destroy them (file photo)

But experts say more long-term data on durvalumab is likely to show it is more effective than nivolumab.

Dr Conibear said: ‘We see in patients with advanced lung cancer already receiving durvalumab on the NHS that it significantly reduces the risk of tumours coming back, so much so that doctors are considering it a cornerstone treatment.

‘The hope is that it will also be possible to cure more patients at an early stage.

‘Life for patients is really hard even after they are discharged. They go through life in constant anxiety about what they will find at the next scan.

‘It is unacceptable that between 30 and 50 percent of patients develop lung cancer again.

“If we can approve a drug that can reduce that number and cure more people, that has to be a good thing.”

A spokesman for Astrazeneca, the British pharmaceutical company that developed durvalumab, said it was “working to provide additional data” to NICE in order to address these points in time for mid-September, when the watchdog will make its final decision on the drug.

A NICE spokesperson said: “It is important to note that this is not definitive NICE guidance on this technology. Recommendations may change following consultation.”

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