WIREDGOV

At the same time as managing the most serious global health threat in a century, the NHS has struck a deal which will see hundreds of people a year benefit from a ‘game-changing’ new cancer treatment.

The new drug, larotrectinib, will initially be used for children, young people and some adults, and targets tumours according to their genetic make-up, rather than where they originated from in the body.

It will be added to the armory of NHS cancer services, which have pulled out all the stops to ensure that vital treatment continues to be available for those who would benefit safely from it.

The revolutionary treatment is the first in a new generation of ‘tumour agnostic’ drugs to be made available on the NHS following the deal endorsed by NICE, the organization that ensures clinical and cost effectiveness.

Larotrectinib, also known as Vitrakvi, can be used against a wide range of cancers and could offer hope to patients with rare forms of the disease that may previously have been untreatable.

NHS chief executive Sir Simon Stevens yesterday said:

“While NHS staff are working around the clock to deal with the global coronavirus pandemic, the NHS is also working hard to make sure that the best care is available for other patients.

“Cancer treatment must be a priority, and that will be advanced by the first in a new generation of drugs that can cure previously untreatable tumours.

“This exciting new breakthrough in cancer treatment is the latest example of how the NHS leads the way in the new era of personalised cancer care, even when pulling out all the stops to respond to coronavirus.

“The benefits for patients, in particular children, of being able to treat many different types of cancers with one drug is potentially huge, helping them to lead longer, healthier lives.”

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, yesterday said:

“Histology independent medicines, like larotrectinib, are an exciting new development in the treatment of cancer. These cutting-edge therapies can be used to treat tumours with often rare genetic mutations regardless of where in the body the tumour originated. The clinical evidence is usually based on extremely small sample sizes, requiring novel approaches to testing them in clinical trials and translation into models of assessment for potential value in NHS practice.

“We’re therefore pleased to be able to recommend larotrectinib for use in the Cancer Drugs Fund while more data is collected on its clinical effectiveness, and we recognise the contribution of our appraisal committee, the company and other stakeholders.”

The drug, manufactured by Bayer, is indicated to treat all solid tumours with confirmed neurotrophic tyrosine receptor kinase (NTRK) gene fusions when standard treatments have failed. NTRK gene fusions are commonly seen in some rare cancers and occasionally in the common cancers.

Amanda Cunnington, head of patient access at Bayer yesterday said:

“Today’s positive announcement regarding access to Larotrectinib for NHS patients in England has been secured as a result of working closely with NICE and NHS England.

“We are now focused on working in collaboration with the NHS at national and local levels so that eligible patients across the country can be identified and treated with Larotrectinib.”

Larotrectinib is set to be available initially for those patients who already have the confirmed NTRK gene fusion and for those groups who are most likely to benefit such as children, teenagers and young adults with rare cancers.

Testing for all relevant patients will be rolled out as soon as capacity is created in the genetic testing service in the NHS through reduced need for coronavirus tests.

Molecular testing for NTRK gene fusions is key to identifying those patients who are most likely to benefit from the treatment and therefore becomes a first and essential element of treatment planning.

Patients in England are ideally placed to benefit thanks to the NHS’s world-leading national genomic medicine and testing service which means they can be identified and tested, allowing faster access to targeted treatment, often when no other options are available.

NTRK gene fusions are thought to drive tumour growth. NTRK gene fusions occur in less than 1% of the common solid tumours such as lung, colorectal and breast cancers and are much more common in certain rare cancers.