CardiovascularUK Patients To Benefit From Access To Innovative Lung Cancer Treatment
The National Institute for Health and Clinical Excellence (NICE) have today published their
recommendation for the use of the innovative chemotherapy pemetrexed (Alimta), in combination with
cisplatin - a platinum based chemotherapy, as a 1st-line treatment for patients with adenocarcinoma or
large-cell carcinoma non-small cell lung cancer* (NSCLC)1 within their Final Appraisal Determination
(FAD).
Final Guidance on the use of pemetrexed and cisplatin within this indication is anticipated to be published
in September 2009 as a result of the FAD. Lilly welcomes this FAD decision which means that UK
patients with adenocarcinoma and large cell carcinoma NSCLC are to benefit from publicly funded access
to the combination as 1st line treatment.
Lung cancer is the UK"s biggest cancer killer2 and the second most common cancer in the UK after breast
cancer2, accounting for one in 20 of all deaths nationwide.
Treatment with pemetrexed and cisplatin represents a significant development in non-squamous NSCLC
treatment as it has shown to extend life beyond one year in certain patients**3. In addition, pemetrexed
with cisplatin offers improved tolerability for non-squamous NSCLC patients3 when compared to the most
widely prescribed treatment combination, gemcitabine and cisplatin. In clinical trials comparing the two
treatment combinations, patients receiving pemetrexed and cisplatin required fewer transfusions,
experienced lower incidence of neutropenia (a disorder leading to a low white blood cell count) and half
the number of patients encountered hair loss.3
Professor Nick Thatcher, Professor in Medical Oncology at The Christie NHS Foundation Trust said: "This
decision is truly significant and is fantastic news for lung cancer patients in the UK and the clinicians who
have been campaigning for access.
"It is NICE"s first FAD incorporating the use of histology. A histological diagnosis, the microscopic analysis
of a tumour biopsy, allows the determination of exactly which type of NSCLC is present***, thereby
allowing treatments to be more targeted and therefore more effective.
"This "targeting" of patients has helped NICE confirm that pemetrexed and cisplatin is a clinically and cost
effective treatment in patients with a confirmed diagnosis of adenocarcinoma or large-cell carcinoma."
"The decision reflects the advancement pemetrexed in combination with cisplatin brings, with clinicians
being able to target the right patients with the right treatment based on histological diagnosis. NICE
should be commended on allowing UK patients to be the first to have funded access to this combination
for the 1st line treatment of non-squamous NSCLC.
"We now need to work hard to ensure that there is equitable access to this medicine throughout the UK."
Pemetrexed and cisplatin are administered as an infusion every three weeks, providing an additional
benefit of reducing the frequency of hospital visits and medication when compared with other treatments.4
The full FAD documentation can be found on the NICE website www.nice.org.uk. Final guidance on the
use of pemetrexed and cisplatin for the 1st line treatment of locally advanced or metastatic non-squamous
NSCLC is expected in September 2009 and will also be published on the NICE website.
Notes
* For patients with locally advanced or metastatic non-small cell lung cancer (NSCLC)
** In patients with adenocarcinoma
*** Of the three types of NSCLC, pemetrexed has been shown to be more effective in two types,
adenocarcinoma and large cell carcinoma (referred to as non-squamous NSCLC). These two types of
NSCLC represent approximately 55% of all NSCLC cases
References
1 - National Institute for Health and Clinical Excellence. Pemetrexed for the 1st line treatment of non-small cell lung cancer. Final
Appraisal Determination: http://guidance.nice.org.uk/TA/Wave18/25
2 - Cancer Research, UK. Cancer Stats, Key Facts on Lung Cancer and Smoking.
http://info.cancerresearchuk.org/cancerstats/types/lung/ (Accessed July 2009)
3 - Scaglotti GV et al. Phase III study comparing cisplatin plus gemcitabine with cisplatin plus pemetrexed in chemotherapy-naive
patients with advanced-stage non-small-cell lung cancer. J Clin Oncol; 2008 Jul 20;26(21):3543-51. Epub 2008 May 27
4 - Alimta SmPC
Eli Lilly and Company Limited