Womb cancer

New NHS treatment for womb cancer following NICE green light

Hundreds of NHS patients are set to benefit from a new treatment option for womb cancer thanks to new guidance from the National Institute for Health and Care Excellence (NICE).

The immunotherapy dostarlimab, which is marketed as Jemperli by its manufacturer GSK, has been shown to improve life expectancy and extend the time before the cancer advances, when combined with chemotherapy.

NICE has recommended dostarlimab for use through the cancer drugs fund (CDF) due to only short-term clinical trial data being available, meaning long-term impact or benefits are unknown.

This will allow NHS patients to access the treatment while more evidence is collected to determine the viability of future routine use.

The short-term data showed that almost two in three (64%) patients saw their cancer not progress after 12 months when treated with dostarlimab and chemotherapy – this is significantly higher than the rate observed in patients undergoing chemotherapy alone (24%).

“Today’s decision is very welcome news, and we hope that this is just the first step…”

Endometrial cancer is the most common form of womb cancer and nearly a quarter (23%) of cases are for subtypes known as high microsatellite instability and mismatch repair deficiency.

Dostarlimab has been recommended for these subtypes when the cancer is advanced or has come back after previous treatment.

NICE has already recommended dostarlimab for this use, but this latest move means the immunotherapy can be shifted to earlier in a patient’s treatment plan – i.e., rather than being given after the disease has progressed following chemotherapy, it can be used in combination with chemotherapy.

The treatment is administered intravenously over 30 minutes every three weeks at a hospital, alongside six cycles of chemotherapy. If patients respond to the treatment, it is continued every six weeks for up to three years.

“Advanced or recurrent womb cancer has a devastating effect on quality of life…”

NICE estimates that 540 adults will have access to dostarlimab following the news. NHS England says 9,400 women are diagnosed with womb cancer each year, making it the fourth most common cancer among women.

Trustee and advocacy lead at Peaches Womb Cancer Trust, Dr Chloe Barr, said: “Today’s decision is very welcome news, and we hope that this is just the first step towards wider availability of more effective first-line treatment options for those affected by this devastating cancer.”

This latest appraisal of dostarlimab signals the fourth treatment option NICE has recommended for endometrial cancer. It follows recommendations of pembrolizumab, pembrolizumab combined with lenvatinib, and dostarlimab alone.

NICE’s director of medicines evaluation, Helen Knight, explained: “Advanced or recurrent womb cancer has a devastating effect on quality of life and there are limited treatment options available.

“We are focused on delivering what matters most and getting care to those who need it fast, so I am delighted this treatment option will be made quickly available through the CDF, enabling people with this type of cancer to enjoy more precious time with their families and loved ones.”

NHS England’s CDF lead, Professor Peter Clark, added that this is great news for patients and the health service is delighted that dostarlimab has become the latest in a series of cutting-edge NHS innovations to improve cancer care.

Image credit: iStock

NHE March/April 2024

NHE March/April 2024

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