NHS England to prioritise 'tumour agnostic' cancer drugs

NHS England is to prioritise cancer drugs that target tumours according to their genetic makeup rather than where they originate in the body, the organisation’s chief executive has said.

Simon Stevens told a conference this week that the NHS must be ready to fast-track these tumour agnostic drugs in the same way as it has CAR-T cell therapies for cancer.

Patients in England were among the first in the world outside the US to receive CAR-Ts outside clinical trials.

As revealed by pharmaphorum, the NHS had prepared for CAR-Ts, and their unique challenges, before they were approved and marketed.

Stevens hopes this has a set a precedent with other novel therapies, including tumour agnostic drugs.

Tumour agnostic drugs are unlikely to be as challenging as CAR-Ts however – the biggest issue with these will likely to be around pricing and ensuring that the testing technology is in place to identify the patients likely to respond.

Roche and Bayer are among the companies that are developing these sorts of treatments – Roche’s Rozlytrek (entrectinib) has just been approved in Japan, and Bayer’s Vitrakvi (larotrectinib) is another example of this approach.

Merck & Co’s Keytruda (pembrolizumab) has also been approved for tumours with “MSI High” mutations, as well as in numerous tumour specific indications.

Stevens said NHS England will work with industry to step up preparations for these drugs, including bringing together cancer specialists to ensure all patients who could benefit from tumour agnostic drugs are identified.

The tests required for genomic mutations will be embedded within existing cancer pathways, said Stevens, and NICE will ensure the unique characteristics of these treatments will be valued appropriately and efficiently.

The Accelerated Access Collaborative – a body established by the government as part of the Life Sciences Industrial Strategy to speed up the adoption and uptake of innovative new treatments – will meet next week to discuss how it can support implementation.

Stevens said at the Confed19 conference this week: “The benefits for patients, in particular children, of being able to treat many different types of cancers with one drug is potentially huge, helping them to lead longer, healthier lives.

“NHS patients in England were at the forefront of the CAR-T revolution and I want to make sure that they are also among the first in the world to benefit from these treatments.

“Preparations are underway to make sure the NHS can adopt these next generation of treatments, but manufacturers need to set fair and affordable prices so treatments can be made available to those who need them.”