Approval of new breast cancer drug offers 'precious hope' for patients

A breast cancer charity has hailed the approval of a new drug to treat women with a particularly aggressive form of the disease, describing it as offering “precious hope” of more lives being saved in the long term.

The Scottish Medicines Consortium (SMC) has recommended pembrolizumab be prescribed to patients with advanced or early stage triple negative breast cancer at high risk of recurrence, as part of other treatments including chemotherapy and surgery.

In addition, the advisory body cleared the use of five other medicines this week including one which will be used to treat patients with an extremely rare disorder affecting how the body accumulates and stores fat.

The committee has accepted the use of metreleptin to treat people with lipodystrophy, a condition through which the body is unable to maintain healthy fat tissue leading to abnormalities and reduced life expectancy.

The drug will be made available to sufferers for three years while further information is gathered about its clinical and cost effectiveness after which SMC will decide whether it should be routinely available across Scotland.

The four other drugs cleared for use this week without caveats were nivolumab for people with cancer of the oesophagus; polatuzumab for adults with diffuse large B-cell lymphoma; treosulfan for people about to undergo a donor stem cell transplant; and upadacitinib for patients with Crohn’s disease.

Melanie Sturtevant, associate director of policy, evidence and influencing at Breast Cancer Now, commented: “It’s brilliant news that certain patients with primary triple negative breast cancer will now be able to access pembrolizumab on the NHS in Scotland.

“This exciting new drug is an important step forward for patients with this type of breast cancer who’ve faced limited treatment options for far too long.

“While less common, triple negative breast cancer can be particularly aggressive and often with poorer outcomes. For those living with the disease and their loved ones, the fear of the cancer returning can be overwhelming.

“Pembrolizumab offers precious hope of more lives being saved from this devastating disease, by significantly reducing the risk of the cancer coming back or spreading to other parts of the body and becoming incurable.

“The treatment may also lead to any detectable cancer disappearing by the time of surgery, meaning patients can potentially face less invasive, breast-conserving surgery.

“We encourage women to discuss their breast cancer treatment options with their healthcare team. Anyone affected by breast cancer can speak to Breast Cancer Now’s expert nurses by calling our free Helpline on 0808 800 6000 for information and support

Meanwhile, the SMC chair, Dr Scott Muir, commented on the approval of metreleptin: “Liposystrophy is a debilitating condition that can result in high morbidity with multi-organ damage of the liver, kidneys and pancreas, poor quality of life and premature death.

“There are no other medicines currently licensed for the treatment of this condition.

“The Scottish Government will announce when metreleptin will be available for prescribing.

“The cost of metreleptin is currently very high; availability via the ultra-orphan pathway will allow the company more time to gather data in order to address key uncertainties identified by the committee.

“Thereafter SMC will reassess the case to ensure that this medicine is a good use of NHS resources.

“We know that triple negative breast cancer can be an aggressive disease with a high risk of occurrence. Adding pembrolizumab to current treatment has been shown to improve response rates which will be welcomed by clinicians and patients in Scotland.”