National Institute for Health and Clinical Excellence (NICE)
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Hundreds of people are set to receive the first immunotherapy drug for advanced cervical cancer through the Cancer Drugs Fund

Hundreds of people with cervical cancer are set to receive the first immunotherapy drug for an advanced form of the disease as NICE yesterday (Wednesday 29 March 2023) published the final draft guidance recommending its use in the Cancer Drugs Fund (CDF).

It is estimated that around 400 people with advanced cervical cancer will be eligible for pembrolizumab (also known as Keytruda and made by Merck Sharp and Dohme) through the CDF.

Clinical trial evidence shows that people on the treatment have longer without their disease getting worse than people having standard care. It also suggests they may live longer overall. But it is unclear how much longer it takes for their cancer to get worse, or how much longer they live for, because the trial hasn’t finished yet.

Because of this uncertainty it is difficult for the NICE committee to establish if the medicine is cost effective. This uncertainty may be reduced by collecting and analysing data from the ongoing clinical trial.

The CDF pays for cancer treatments while data is collected on their clinical effectiveness. This means people can have earlier access to treatments while further clinical evidence is generated. This data is then used when NICE re-evaluates a treatment to decide whether it is clinically and cost effective to be used routinely on the NHS.

Helen Knight, director of medicines evaluation at NICE, yesterday said:

“We have recommended 53 cancer treatments for use in the CDF since 2016, benefitting around 55,000 people. Most treatments funded by the CDF are subsequently recommended by NICE for routine NHS use.

“People with advanced cervical cancer have limited treatment options beyond standard care and an effective treatment would be welcomed.

“Pembrolizumab shows promise as the first effective immunotherapy. However, to ensure the best use of limited public funding, we need additional evidence to fully analyse its clinical and cost effectiveness before it can be considered for routine NHS use.

“Recommending pembrolizumab to the CDF means people have faster access to care while this further evidence is gathered.”

Health Minister Helen Whately yesterday said:

“Today is a win for women, offering the hope of more precious time with loved ones.  

“We are committed to providing world-class cancer care to patients and always working to find trailblazing, new treatments.

“This has been made possible by the government’s £340 million Cancer Drugs Fund, which has helped thousands of patients to benefit from rapid access to promising new cancer treatments.”

NICE’s draft guidance recommends pembrolizumab with chemotherapy (with or without bevacizumab) as an option for treating persistent, recurrent or metastatic cervical cancer in adults whose tumours express programmed cell death ligand 1 (PDL1) with a combined positive score (CPS) of at least 1 if the pembrolizumab is stopped at 2 years of uninterrupted treatment.

Cervical cancer develops when abnormal cells in the cervix lining grow in an uncontrolled way, forming a tumour. Nearly all cervical cancers are caused by an infection from certain types of human papillomavirus (HPV). It can often be prevented by attending cervical screening, which aims to find and treat changes to cells before they turn into cancer.

Cervical cancer is defined as persistent when it does not respond to treatment. It is defined as recurrent when it has returned after treatment, and metastatic when it has spread beyond the cervix to other places in the body.

Standard care for persistent, recurrent or metastatic cervical cancer includes chemotherapy with or without bevacizumab.


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