Hundreds of women with advanced womb cancer in England are to be offered a new ‘lifeline' option from today, as the NHS rolls out a life-extending new combination therapy that can halt the progression of the disease for twice as long as chemotherapy.
The NHS has agreed landmark commercial deals for two drugs from different manufacturers, which will be used in combination to treat advanced endometrial cancer in between 500 and 750 women each year.
Clinical trials have shown that pembrolizumab (Keytruda®) and lenvatinib (Lenvima®) used together can double the time taken for cancer to progress compared with the existing chemotherapy treatment, from just over three and half months to more than seven months.
In the trial, overall survival was also significantly longer for patients taking the combination therapy compared to existing chemotherapy treatments, with those taking pembrolizumab and lenvatinib living on average almost 19 months compared just under 12 months on existing chemotherapy.
Set for approval today by the National Institute for Health and Care Excellence (NICE), lenvatinib and pembrolizumab have been shown to work together to stimulate the body's immune system and kill off cancer cell growth. The combination treatment is being funded by the NHS immediately and will be offered to all eligible women who have previously received treatment for advanced or recurrent endometrial cancer.
As part of the combination treatment, pembrolizumab is delivered intravenously every three or six weeks while lenvatinib is two pills taken once a day. Currently patients undergo chemotherapy treatment every three weeks, but unlike with chemotherapy, there is a far less significant risk of hair loss as a side effect of the new combination treatment.
Around 9,400 women are diagnosed with cancer in the womb every year, making it the fourth most common cancer in UK women. Endometrial carcinoma is the most common type of womb cancer, and while it often has a better prognosis than other womb cancers if diagnosed early, advanced or recurrent endometrial carcinoma can be challenging to treat with short survival times.
While the treatment was initially rejected in draft guidance by NICE on the grounds of cost-effectiveness, the NHS has been able to use its commercial capabilities to negotiate a deal with the manufacturers, allowing the treatment to be made available to patients.
NHS national cancer director Professor Peter Johnson said: “It is fantastic news that this innovative combination therapy can now offer a new lifeline to hundreds of women living with advanced endometrial cancer, giving hope of precious extra time to live with a better quality of life.”
“Now in its 75th year, the NHS is leading the world in making the latest treatments available through its unique commercial capabilities and commitment to innovation on behalf of patients and their families across the country.”
Minister for Health Helen Whately said: “We are working with the NHS and world leading scientists to support new cancer treatments like these - improving the lives of hundreds of women diagnosed with womb cancer.
“Cancer survival rates are improving and record numbers of people are receiving treatment.
“But we know there's more to do. That's why today we announced our call for evidence to inform our Major Conditions Strategy - a plan to better diagnose and manage six conditions including cancer.”
Grace Teeling, 33 was first diagnosed with advanced stage three womb cancer in 2019. Following chemotherapy, Grace who is originally from Bristol, had a recurrence of the tumour at approximately eight months in bowel and pelvic area. She had surgery followed by drug treatment with pembrolizimab and the remaining tumour disappeared within six months, with no evidence of return for around 18 months.
She said: “I have been incredibly fortunate to receive treatment for the past two years and I had a really good response, which means there is currently no evidence of cancer on my recent scans. It has also enabled me to thrive despite having an advanced and incurable cancer diagnosis.
“I am able to work, travel, socialise and exercise, including paddleboarding, which I may not have been able to do on chemotherapy. I am delighted others will now be able to access this treatment as I don't think I would be alive today if I hadn't.”
Professor Emma Crosbie, Chair of Trustees of Peaches Womb Cancer Trust, said: “This innovative new treatment regimen will benefit patients with advanced or recurrent endometrial cancer, who currently have very few effective anti-cancer treatments available to them. Every year, many people are facing a diagnosis of advanced or recurrent womb cancer, and the frightening reality of very few treatment options that can improve their survival and quality of life. Those affected by womb cancer deserve more treatment options, but we hope that this is just the first step towards wider availability of more effective treatment options for those affected by this devastating cancer.”
Helen Knight, director of medicines evaluation at NICE, said: “NICE's priority is to get the best care to patients fast while ensuring value for the taxpayer. There are currently few treatments for advanced endometrial cancer so this combination therapy is an important addition, providing women with the hope of valuable additional time with their loved ones.”
David Long, Head of Oncology at MSD UK, which manufactures pembrolzimab, said: “Endometrial cancer is one of the few cancers with rising incidence and mortality, and historically there has been limited treatment options for people with advanced stages of the disease. We are therefore very pleased that a new treatment option has been made available to patients which will help address this unmet need. We are proud to have worked alongside Eisai, NICE and NHS England to ensure patients can access this treatment.”
Pam Ganju, Head of Oncology, Eisai UK, which manufactures lenvatinib said: “Previously treated advanced endometrial cancer is frequently untreatable, with the disease having a devastating impact on a patient's quality of life. This impact doesn't just affect physical health; mental health and general wellbeing are also greatly affected. The lenvatinib and pembrolizumab clinical development program has been specifically designed for hard-to-treat cancers such as this, and the positive decision from NICE is a beacon of hope for patients in England for a longer and fuller life.”