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Eleanor Hayward, Health Correspondent, Tuesday December 20 2022, The Times
Hundreds of women with incurable breast cancer will be granted precious extra months of life thanks to a breakthrough drug approved for NHS use.
The National Institute for Health and Care Excellence (Nice), the medical watchdog, approved Enhertu, or trastuzumab deruxtecan, yesterday to be rolled out to 600 women a year in England.
Trials show the drug improves survival, stops tumours spreading and gives patients an extra 22 months, on average, before the disease progresses.
It will be offered to women with HER2-positive breast cancer, a type of the disease that tests positive for a protein called human epidermal growth factor receptor 2 (HER2). This protein, which applies to about a fifth of breast cancer patients, promotes the growth of the cells.
Patients will be eligible if their cancer has not responded to other treatments, cannot be removed by surgery and is metastatic, meaning it has spread.
Advanced breast cancer is incurable but Enhertu slows the spread of the disease, giving patients extra months or years to spend with friends and family.
The drug, given by an intravenous drip once every three weeks, hunts the cancer cells and binds to the HER-2 protein on their surface, before delivering a dose of chemotherapy directly to the tumour. Enhertu is one of a new breed of cancer drugs known as antibody-drug conjugates, made up of artificial antibodies. They seek out cancer cells and don’t harm healthy cells so can be given in higher doses than chemotherapy, with fewer side effects.
Breast cancer is the most common form of the disease in the UK, with 56,000 new cases each year and 11,500 deaths.
Nice said the drug has been fast-tracked for use in the NHS through the Cancer Drugs Fund but it was waiting for more evidence on Enhertu survival times before recommending it for routine use.
A course of Enhertu officially costs about £118,000 but AstraZeneca lets the NHS have it at a confidential discount.
The drug was first approved for use on the NHS last year but for only a tiny subset of advanced patients with high levels of HER2 on their tumours. The latest announcement means about 600 women a year will get the drug as part of their NHS treatment.
Baroness Morgan of Drefelin, chief executive of Breast Cancer Now, said the approval was “fantastic news” for patients who “desperately need new effective treatments”.
She added: “This targeted treatment can significantly slow the spread of the disease compared to the current standard treatment, giving people more time to continue doing the things that matter to them.
“This decision highlights the continued importance of the Cancer Drugs Fund in enabling promising treatments to reach patients on the NHS quickly.
“It shows what is possible when NHS England, Nice and the pharmaceutical industry work together.”
Professor Peter Clark, who leads the NHS England Cancer Drugs Fund, said: “This cutting-edge drug will give hundreds of patients with secondary incurable breast cancer hope.
“The NHS is committed to providing the very best treatments for its patients and trastuzumab deruxtecan is just the latest of more than 100 cancer treatments that have been fast-tracked for use on the NHS through the Cancer Drugs Fund, benefiting more than 80,000 patients.”
Professor Peter Schmid, of Barts Cancer Institute, said the drug had the potential to “redefine the treatment” of women with HER2-positive metastatic breast cancer.
Dr Oonagh McGill, of AstraZeneca UK, said: “There remains a high level of unmet need in breast cancer and this approval represents an important step in our mission to bring new treatment options to UK
I cannot help wondering why women have to wait for other treatments to have failed and for their cancer to have spread before being offered this new drug. What’s the point? Is there any good medical (as opposed to financial!) reason for opting for treatment when prevention might be available????
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