NHS chiefs have been urged to reverse their decision to reject a breakthrough lung cancer drug that slashes the chance of the disease returning by a third.
Durvalumab has been shown in trials to be effective at curing patients with the most common form of lung cancer when combined in the early stages of the disease alongside chemotherapy and surgery.
US health officials last month approved the £70,000-a-year infusion for this patient group – benefiting thousands.
And it is already offered on the NHS for those with advanced lung cancer that has spread throughout the body and who have failed to respond to other treatments.
However, experts were shocked when, two weeks ago, the NHS spending watchdog, the National Institute for Health and Care Excellence (NICE), concluded it would not follow the US and approve durvalumab for early stage lung cancer.
NHS chiefs have been urged to reverse their decision to reject a breakthrough lung cancer drug that slashes the chance of the disease returning by a third (stock photo)
It claimed that it was unclear how much more effective the drug is than existing treatments.
But experts disagree and argue that NICE should reconsider its position – allowing around 1,500 patients to benefit every year.
Dr John Conibear, a clinical oncologist at Barts Cancer Centre, said: ‘Durvalumab is a really important step forward for a patient group who urgently need more options.
‘The risk of the cancer returning for these patients is high even after surgery and we know that giving durvalumab before and after surgery significantly increases the time patients remain cancer-free.
‘It’s disappointing that NICE chose not to approve it and I hope it will reconsider the decision.’
Someone in the UK is diagnosed with lung cancer every ten minutes – amounting to about 50,000 new patients each year – and just a quarter survive five years.
Some 35,000 die of it annually, making it the UK’s biggest cancer killer. The most common form of the disease is non-small cell lung cancer, which accounts for roughly 80 per cent of new cases.
This cancer is predominantly triggered by smoking and is most common in people in their 60s and 70s.
Durvalumab has been shown in trials to be effective at curing patients with the most common form of lung cancer when combined in the early stages of the disease alongside chemotherapy and surgery (stock photo0
When caught before it has spread outside of the lungs, it is treated with a combination of chemo, an immune-boosting drug called nivolumab and then surgery to remove the tumours.
However, more than half will see the disease return within five years.
When this happens, it becomes more resistant to conventional treatments and the majority of patients do not live longer than three years after this occurs.
Durvalumab is a PD-L1 inhibitor, which means that it helps the body spot cancer cells hiding from the immune system, allowing it to target and destroy them.
It is given as four, monthly infusions alongside chemotherapy before surgery, and then on its own following the procedure for a further year.
In 2023, data from an international 800 participant trial concluded that there was a 32 per cent reduction over four years in the risk of the cancer returning or patients dying when compared to chemotherapy alone.
However, NICE argues that since the trial does not directly compare the effectiveness of durvalumab with the existing drug nivolumab, it could not say with certainty whether the drug was worth its costly price tag.
Nivolumab, first approved for lung cancer in 2017, costs roughly £68,000 per course.
NICE also raised concerns that a recent study found one in five patients suffered side effects, including nausea, constipation, fatigue and muscle pain.
Similar side effects are seen in around one in ten nivolumab patients.
Durvalumab is a PD-L1 inhibitor, which means that it helps the body spot cancer cells hiding from the immune system, allowing it to target and destroy them (stock photo)
But experts argue further long-term data on durvalumab is likely to prove it is more effective than nivolumab.
Dr Conibear said: ‘We see in the advanced lung cancer patients who already get durvalumab on the NHS that it significantly reduces the risk of tumours returning, so much so that doctors consider it a cornerstone treatment.
‘The hope is that it will similarly be able to cure more of these early-stage patients.
‘Life for patients is really tough even after they get the all-clear. They spend their lives in constant anxiety about what the next scan will find.
‘It’s unacceptable that between 30 per cent to 50 per cent of patients see their lung cancer come back.
‘If we can approve a drug which can bring that number down and cure more people, that’s got to be a good thing.’
A spokesperson for Astrazeneca, the British drug firm that developed durvalumab, said it was ‘working to provide additional data’ to NICE in order to address these points in time for mid-September when the watchdog will make its final decision on the drug.
A spokesperson for NICE commented: ‘It’s important to note that this isn’t NICE’s final guidance on this technology. The recommendations may change after consultation.’
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