BLADDER cancer patients whose tumours have spread are set to get a new drug on the NHS for the first time in 25 years.
The immunotherapy drug pembrolizumab – also known by the brand name Keytruda – has been shown to prolong survival by an extra three months on average compared to chemotherapy.
The Scottish Medicines Consortium has approved the drug for locally advanced or metastatic urothelial carcinoma – the most common form of bladder cancer – in patients who have previously undergone platinum-containing chemotherapy.
It is expected to benefit around 50 patients a year.
Robert Jones, Professor of Clinical Cancer Research and Honorary Consultant in Medical Oncology at Glasgow University, said: “Bladder cancer is a common disease and, though many can be cured, some may not survive once the disease becomes advanced.
“Pembrolizumab is the first life-prolonging drug for patients with advanced bladder cancer in 25 years, so it’s great news for patients with this disease that the NHS in Scotland will now make it available. The news is particularly welcome as, prior to this, there were few life-prolonging treatment options for patients who had previously received platinum containing chemotherapy.”
Read more: Immunotherapy drug which made tumours ‘vanish’ approved for NHS Scotland
Pembrolizumab is already available on the NHS in Scotland as a treatment for advanced lung and skin cancers. It was branded a “wonder drug” after former US President Jimmy Carter credited it with making his tumours “vanish” in 2016 after advanced melanoma spread to his brain, a condition which would usually be fatal.
A clinical trial involving 305 lung cancer patients the US was cut short in 2016 after results showed that it cut the risk of death or tumours spreading by 50 per cent compared to chemotherapy. It was deemed unethical not to extend the therapy to everyone in the study.
Keynote-045, the clinical study the SMC based its decision on for advanced bladder cancer, found that pembrolizumab typically extended survival to around 10 months – compared with seven months for chemotherapy.
Read more: ‘Unreasonable delay’ for Glasgow bladder cancer patient who later died
Around 830 people a year are diagnosed with bladder cancer in Scotland, with the disease claiming 520 lives in 2016. Around a third of cases are caused by smoking. It is the eighth most common cancer in men, and 9th most common in women in Scotland, but it is the only top ten cancer where the prognosis is getting worse – partly due to very low research spending. In 2013/2014, only 0.6 per centof dedicated research funding was given to bladder cancer
Once bladder cancer is advanced, only 10 per cent of patients will survive more than five years – but if caught early five-year survival rates can be as high as 80 per cent.
One of the most common symptoms is blood in the urine. Sometimes this is clearly visible, but in many cases it can only be picked up when tested by your doctor and there are no accepted screening tests for bladder cancer.
Allen Knight, chairman of Action Bladder Cancer, said: “Bladder cancer is often given a Cinderella status. It is encouraging to see more treatment options being available to people with urothelial carcinomas and as an organisation we are thoroughly excited as to what this means for the future.”
Read more: Doctor urges patients not to ignore blood in urine
Andrew Winterbottom, a bladder cancer patient and chief executive of Fight Bladder Cancer, said the organisation was “absolutely delighted” by the SMC decision.
Mr Winterbottom added: “A long-neglected and ignored cancer finally has a new treatment option following platinum-containing chemotherapy which could provide a step change in the treatment options for Scottish patients. This is an important milestone for our community.”
This recommendation comes with the restriction that treatment with pembrolizumab is subject to a two-year clinical stopping rule.
SMC chairman Dr Alan MacDonald said: “We are pleased to be able to accept these medicines for use by NHS Scotland.
“Pembrolizumab offers patients with advanced bladder cancer the potential for a better quality of life during valuable additional months with their families.”
Source : HeraldScotland