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The Guardian - UK
The Guardian - UK
Politics
Andrew Gregory Health editor

Two breast cancer drugs available on NHS in England after U-turn

A consultant studying a mammogram.
A consultant studying a mammogram. Photograph: Rui Vieira/PA

Thousands of breast cancer patients in England are to benefit from two new drugs available on the NHS following a U-turn by the health watchdog.

About 3,500 women a year will benefit from life-extending drugs Alpelisib and Trodelvy, which have now been given the green light despite being rejected earlier this year by the National Institute for Health and Care Excellence (Nice).

Alpelisib, made by Novartis, is used in combination with the hormone therapy Fulvestrant, to target the gene that causes fast-growing tumours. The drug, also known as Piqray, when used with Fulvestrant works by blocking the gene’s ability to help cancer cells to survive and grow.

One study showed half of people who received the treatment combination after previous therapies were able to stop the growth of their cancer for six months.

People with a mutation in the specific gene called PIK3CA will be eligible for treatment if they have explored other treatment options, with an estimated 3,000 to benefit each year.

John Stewart, national director for specialised commissioning for the NHS in England, said the treatments would help thousands of patients to live a better quality of life.

“This life-extending breast cancer treatment is the 100th to be rapidly made available to NHS patients thanks to the Cancer Drugs Fund, and will help people with secondary breast cancer to live longer.”

Meanwhile, Trodelvy, also called Sacituzumab Govitecan and made by Gilead Sciences, has also been approved to treat a type of cancer which cannot be removed surgically. The drug can benefit women with triple negative incurable secondary breast cancer.

Triple negative breast cancer is more common in women under 40 and affects about 15% to 20% of all women with the disease. About 650 patients will be given access to Trodelvy.

Nice said the aim of the new treatment is to target a protein on the surface of the tumour cells which eventually causes them to die.

Clinical trials show the drug can slow progression of the disease by several months and extend a person’s life by around five months compared with traditional chemotherapy.

Nice said the drug can be considered as a treatment option after women have already received “two or more systemic therapies”.

Baroness Delyth Morgan, the chief executive of Breast Cancer Now, said: “The news that Trodelvy has finally been recommended by Nice for use on the NHS in England, marks a momentous and hugely anticipated milestone for certain women living with incurable triple negative secondary breast cancer.

“Following a devastating provisional rejection in April, this landmark decision will offer a new, effective treatment for these women, and crucially give them the hope of invaluable extra months to live and do what matters most to them and their loved ones.”

Both the drugs are to be made available by the NHS in England through the Cancer Drugs Fund.

Helen Knight, interim director of medicines evaluation at Nice, said: “Both Piqray and Trodelvy are effective additional options that hold out the hope of a longer and a better quality of life for people with these types of advanced breast cancer.

“And both represent another step in delaying chemotherapy, allowing people to stay well for longer.

“We are pleased that the companies which make these drugs have been able to work so constructively with us and NHS England to agree deals which mean we can make both available routinely on the NHS for around 3,450 people with these types of advanced breast cancer.”

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