28.03.2019

Lung cancer treatment trialled in Newcastle available on the NHS

A new immunotherapy drug shown to reduce the risk of death in some lung cancer patients by a third is now available on the NHS in England, thanks to a new NICE recommendation.

The drug, durvalumab was trialled by cancer experts at Newcastle’s Northern Centre for Cancer Care (NCCC), and is offered to patients diagnosed with advanced (stage 3) non-small cell lung cancer who have already undergone platinum-based chemoradiation.

James Richardson, Zoe Collins and Dr Alastair Greystoke in the Northern Centre for Cancer Care

Durvalumab is a PD-L1 inhibitor - it works by helping the body’s immune system to find and attack cancer cells, by blocking the PD-L1 protein which disguises cancer.

In clinical trials, people were seen to take durvalumab for an average of two years without the disease progressing, versus six months for those without. It was also shown to reduce risk of death by a third compared to current standards of care treatment.

Dr Alastair Greystoke, an honorary consultant medical oncologist at NCCC, led the team that treated patients on an early access scheme.  They include James Richardson, a senior lead pharmacist for cancer services, and Zoe Collins, senior sister on the day unit at NCCC. 

He says: “My colleagues at NCCC really do go above and beyond to make sure we can deliver cutting edge treatments to all our patients, in and out of trials.

“This particular therapy is the biggest advance we’ve seen for a number of years in treating locally advanced non-small cell lung cancer. It’s fantastic news for patients and, working alongside chemotherapy and radiation, offers the potential for a cure and the best treatment possible.”

Dr Greystoke, also a Clinical Senior Lecturer at Newcastle University’s Northern Institute for Cancer Research continued: “We hope this will equate to increased cure, however, we won’t know for definite for another couple of years as these cancers can come back several years after treatment.”

Lung Cancer is the most common cancer in men, second most common in women and is the leading cause of cancer-related death with around 600 patients in the UK receive chemotherapy and radiotherapy for stage 3 non-small cell lung cancer each year.

NICE has accepted that early evidence shows durvalumab to be a “promising” new treatment and recommended its use within the Cancer Drugs Fund, while more data is collected.

Made by AstraZeneca and offered to the NHS at a discounted price, the drug could benefit around 165 people in England in its first year, with more to follow, according to NICE.

Meindert Boysen, director of the Centre for Health Technology Evaluation at NICE, said: “The Cancer Drugs Fund gives patients faster access to the most promising cancer treatments.

“We are pleased to make this exciting new option available and look forward to seeing further data on the effectiveness of durvalumab.

“After relatively few developments in the past two decades for people with this type of lung cancer, this decision will be particularly welcome to those with the condition, their families and the healthcare staff and experts working with them.”

Stage 3 is when cancer has spread within the lungs and possible lymph nodes, but has not yet reached other parts of the body.

Unlike stage 4, also known as metastatic, where the goal of treatment is to prolong life and provide palliative care, there may still be a chance of cure for some patients with stage 3 disease.

Dr Greystoke added: “Durvalumab will be available for patients who have received combined chemotherapy and radiotherapy for local advanced lung cancer which has not spread away from the chest, but equally cannot safely be removed by a surgeon.

“The patients have to have responded to the chemo-radiotherapy and be fit for treatment and their tumour needs to express PDL1 - the target for durvalumab - which is in about two thirds of lung cancer.

“We hope this will lead to an increased chance of cure, but we need to follow-up the patents who were treated on the trial for longer to see if this is definitely the case.”

Press release adapted with thanks to Newcastle University

Case Study:  Denise Walker

When 50 year old Denise Walker was told by doctors last year that she had stage 3 non-small cell lung cancer too close to the heart to operate she was shocked. Given a possible 1:4 chance of surviving the disease, Denise underwent an immediate and intensive course of chemotherapy and radiotherapy – the standard treatment for this type of cancer.

Denise says: "It was quite a shock - I had been feeling a bit unwell, but was more devastated about how it would affect kids. They were sitting their A-levels and GCSEs and I was worried they would be too worried about me."

Midway through her treatment, Denise was offered the chance to take durvalumab as part of the clinical trial led by Dr Greystoke.

She adds: "It's less invasive, you don't feel so lonely like with chemotherapy because you've got to watch for picking up any bugs.

"Immunotherapy is totally different. You can interact with people, and just enjoy your life that bit more whilst you're going through the treatment."

So much so, Denise went to New York with friends to celebrate her 50th birthday, helped her children with their exams, and went back to work.

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