Posted by Michael Wonder on 11 Jul 2016
SMC - July 2016 decisions
11 July 2016 - Two new medicines for lung cancer among five treatments accepted for routine use in NHS Scotland.
The SMC has today published advice accepting five new medicines for routine use in NHS Scotland. Two of these medicines, used to treat different types of lung cancer, were accepted through the Patient and Clinician Engagement (PACE) process, for medicines that treat end of life and very rare conditions.
Crizotinib (Xalkori) can be used to treat a very rare form of advanced, incurable lung cancer where the cancer cells contain certain defects affecting the gene responsible for a key protein called anaplastic lymphoma kinase (said to be ‘ALK positive’). Crizotinib targets this specific kind of cancer cell and as such is thought to be a therapeutic advancement. In the PACE meeting, patient groups and clinicians highlighted that this form of lung cancer generally affects a younger age group, who may have significant work and family commitments. Average survival for those with this type of cancer is less than a year. Crizotinib can delay progression of the disease for an average of four months, giving patients valuable extra time with a better quality of life in the context of the limited overall survival time. As the medicine is taken orally it also reduces the number of hospital visits required compared to the current treatment option which is chemotherapy. Crizotinib may also have fewer side effects compared to chemotherapy.
Nivolumab (Opdivo) was accepted for the treatment of a different form of lung cancer known as squamous non-small cell lung cancer (NSCLC). PACE participants highlighted that squamous NSCLC is a particularly aggressive sub-type of lung cancer with few treatment options, and patients tend to be diagnosed with late stage disease and often have a poor prognosis. Nivolumab is the first immunotherapy to be licensed for lung cancer, and it works by increasing the ability of the immune system to kill cancer cells. It can offer patients an extra three to four months survival time and improved quality of life, which is extremely valuable in the context of a limited overall survival time of around six months.
