NHS approves life-extending drug for women diagnosed with one of deadliest types of breast cancer

A drug for women with one of the most aggressive types of breast cancer has been given the green light for NHS use in England.

Triple-negative breast cancer is responsible for one in four breast cancer deaths.

But around 1,600 patients a year in England will now be offered pembrolizumab, which reduces the chances of the cancer progressing by 40 per cent.

Research suggests the immunotherapy drug, given intravenously with chemotherapy before breast cancer surgery, can potentially lead to the disappearance of any detectable cancer.

The National Institute for Health and Care Excellence (Nice) approved pembrolizumab for women with primary triple-negative breast cancer, where the cancer has a high risk of returning after treatment.

Immunotherapy drug pembrolizumab, brand name  Keytruda has been approved for women with an advanced form of  breast cancer after a previous rejection

Helen Knight, interim director of medicines evaluation at drugs watchdog Nice, said: ‘Triple negative breast cancer has a relatively poor prognosis and there are few effective treatments compared with other types of the disease.

‘Today’s draft guidance means that we have now recommended three new treatments for routine use in the NHS since June, helping to address this unmet need and giving hope of a longer and a better quality of life to thousands of people.’

Baroness Delyth Morgan, chief executive at Breast Cancer Now, said: ‘For far too long, patients with this type of breast cancer have faced the frightening reality of limited treatment options.

‘This new treatment can potentially lead to any detectable cancer disappearing by the time of surgery, meaning patients will then possibly face less invasive, breast-conserving surgery.’

Triple-negative breast cancer accounts for around 15 per cent of all breast cancer cases.

It is more common in women under 40, black women and those with a mutation of the BRCA2 or BRCA1 gene — dubbed the ‘Jolie gene’ because the mutation was carried by Hollywood actress Angelina Jolie, who had a mastectomy to reduce her risk of breast cancer.

Pembrolizumab can completely wipe out breast cancer cells before surgery, so that some women no longer need a mastectomy but can keep their breasts and have a smaller operation to remove a lump instead.

It is more common in women under 40, black women and those with a mutation of the BRCA2 or BRCA1 gene ¿ dubbed the 'Jolie gene' because the mutation was carried by Hollywood actress Angelina Jolie, who had a mastectomy to reduce her risk of breast cancer

It is more common in women under 40, black women and those with a mutation of the BRCA2 or BRCA1 gene — dubbed the ‘Jolie gene’ because the mutation was carried by Hollywood actress Angelina Jolie, who had a mastectomy to reduce her risk of breast cancer

The drug also reduces the likelihood of triple-negative breast cancer coming back after treatment and spreading to other parts of the body, becoming incurable.

That means it brings hope of more lives potentially being saved from the devastating disease.

For those whose cancer does come back, this could take longer if they are on the drug, although no benefits have yet been found showing pembrolizumab helps people to live longer.

The drug, which is also know as Keytruda and made by the company MSD, blocks a protein on the surface of certain immune cells in the body which makes cancer invisible to them.

When the protein is blocked, these immune cells can detect and kill tumour cells.

The NHS in England said it has struck a deal with the manufacturer to get pembrolizumab to breast cancer patients as soon as possible.

The drug is set to be fast-tracked into the Cancer Drugs Fund, so should be available this month.

Women will be given it every three to six weeks for around a year.

This is the second new drug for triple-negative breast cancer to be made available on the NHS this year after Trodelvy was recommended for women with incurable cancer by NICE in June.

NHS chief executive Amanda Pritchard described the deal as a ‘hugely significant moment for women’, adding: ‘It will give hope to those who are diagnosed, and prevent the cancer from progressing, allowing people to live normal, healthy, lives.’

I had to cancel my dream wedding because I was diagnosed with cancer… now I’m free of the disease after taking this drug 

What is pembrolizumab and how does it work? 

What is pembrolizumab?

Pembrolizumab is a type of immunotherapy. It is also known by its brand name, Keytruda.

You might have it as a treatment for:

  • non small cell lung cancer (NSCLC)
  • melanoma skin cancer
  • bladder cancer
  • Hodgkin lymphoma

You might also have pembrolizumab as part of a clinical trial for another type of cancer.

How does it work?

Pembrolizumab is a type of immunotherapy. 

It stimulates the body’s immune system to fight cancer cells.

Pembrolizumab targets and blocks a protein called PD-1 on the surface of certain immune cells called T-cells. 

Blocking PD-1 triggers the T-cells to find and kill cancer cells.

Source: Cancer Research UK 

It was four months before Lauren Sirey was due to walk down the aisle that she was diagnosed with triple-negative breast cancer.

Suddenly, rather than worrying about the flowers being wrong or the caterer not turning up, she was having to cancel her wedding and start chemotherapy.

On top of it all, she was facing the prospect of a mastectomy at the age of 31.

But after starting a course of pembrolizumab in a clinical trial, the lump in her breast started to disappear and she felt more confident making the choice to have a lumpectomy instead.

Miss Sirey, now 36, said: ‘There was a lot of drama with losing £10,000 from the cancelled wedding and having to face being ill with breast cancer when I felt far too young.

‘I felt having a mastectomy would be even more psychologically damaging, but the treatment made me feel more confident that I could have a lumpectomy.

‘Now I just have a tiny scar under my armpit and you would never know I had breast cancer.

‘More importantly, I feel lucky to know I have a reduced chance of the cancer coming back because of this drug.’

The mental health nurse is now five years cancer-free and planning to celebrate with her fiancé, 38-year-old account manager Craig Miller, in Las Vegas.

The couple, who live in Godalming, Surrey, also plan to finally have their wedding either next year or in 2024.

Miss Sirey recently ran a 10k race for a breast cancer charity.

She said: ‘This treatment helped me to make a full recovery and I am delighted to hear it has now been approved for use in the NHS.’

Miss Sirey is going to Las Vegas next March and ran the 10k for breast cancer charity the Bennos Boobs Foundation.

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