More than 1,500 people each year in England diagnosed with an aggressive form of stomach cancer are set to benefit from a new treatment available on the NHS, following NICE’s recommendation of durvalumab.
The decision marks a major milestone in cancer care, as durvalumab (Imfinzi) becomes the first immunotherapy approved for this group of patients, offering new hope for improved survival and outcomes.
This streamlined approach means eligible patients will be able to receive treatment significantly faster than under standard evaluation timelines, reflecting growing efforts to ensure quicker access to innovative medicines.
Gastric and gastro‑oesophageal junction cancers – which develop in the stomach or where it meets the oesophagus – are often diagnosed at an advanced stage.
Even when surgery is possible, recurrence is common, and only around half of patients survive five years after diagnosis.
Clinical experts told NICE that long‑term outcomes for patients remain poor, underlining the need for new treatment options.
Durvalumab is an immunotherapy that works by targeting the PD‑L1 protein, which cancer cells use to evade detection by the immune system.
By blocking this protein, the drug enables the immune system to recognise and attack cancer cells more effectively, improving the body’s natural response to the disease.
The treatment is administered as an intravenous infusion every four weeks, and is used alongside and after chemotherapy and surgery.
Clinical trial data shows that combining durvalumab with FLOT chemotherapy – both before and after surgery – significantly improves outcomes compared with chemotherapy alone.
Patients receiving durvalumab experienced:
- An average of just over 40 months before cancer progression, compared with just over 32 months for chemotherapy alone
- A three‑year survival rate of 68.6%, compared with 61.9% under standard treatment
These findings demonstrate that the therapy can not only extend survival but also delay the return or worsening of disease.
Durvalumab has been recommended for adults whose cancer:
- Has not spread extensively
- Can be treated with surgery
The treatment will be given in combination with chemotherapy before surgery to shrink tumours, followed by continued use afterwards to help prevent recurrence.
This integrated approach aims to improve both short‑term treatment success and long‑term outcomes.
Experts highlighted that recurrence after surgery is a major challenge in stomach cancer, meaning many patients face limited long‑term options.
The introduction of immunotherapy in this setting represents a significant step forward, offering an additional layer of treatment to help control the disease.
NICE applied its light‑touch, streamlined appraisal process to assess durvalumab, allowing guidance to be issued quickly without the need for a full committee meeting.
This approach is increasingly used for high‑impact treatments where there is strong clinical evidence, helping patients access new therapies sooner while maintaining robust evaluation standards.
The introduction of durvalumab is expected to:
- Improve survival outcomes for patients
- Reduce the risk of cancer progression or recurrence
- Enhance quality of life during and after treatment
For the NHS, the treatment also supports a shift towards more personalised and targeted cancer therapies, improving efficiency and effectiveness in care delivery.
Sheena Dewan, Executive Director at Stomach Cancer UK, commented:
“Stomach Cancer UK welcomes NICE’s positive appraisal of durvalumab in combination with FLOT for people with operable stomach and gastro-oesophageal junction cancer in England. This is the first major advance in curative-intent treatment for stomach cancer in nearly a decade.
"Adding immunotherapy to perioperative chemotherapy offers a real opportunity for lower recurrence and longer survival. For too long, patients have been enduring the dual burden of life-altering surgery and high rates of recurrence.
“This treatment gives individuals and families living with the constant fear that the cancer will return a meaningful opportunity for more time with loved ones, more time at work and more time to live well beyond treatment. We are grateful to NICE for its careful consideration of the evidence and for recognising the importance of progress in a cancer that has historically had limited available treatment options.”
The approval of durvalumab marks a major development in the treatment of stomach cancer, particularly for patients who are eligible for surgery.
By combining immunotherapy with existing treatments, clinicians now have a more powerful approach to tackling a disease that has historically been difficult to treat.
With the therapy now available on the NHS, thousands of patients are expected to benefit from improved outcomes and extended survival.
Image credit: iStock
