NICE backs NHS funding for MSD's Keytruda combination in lung cancer

NICE has backed regular NHS funding England and Wales for Merck, Sharp and Dohme’s Keytruda in combination with pemetrexed and platinum chemotherapy in certain lung cancer patients.

In draft guidance NICE said the Keytruda (pembrolizumab) and chemo combination can now be reimbursed by the NHS in adults with untreated non-squamous non-small cell lung cancer (NSCLC) whose tumours have no epidermal growth factor (EGFR) or anaplastic lymphoma kinase (ALK) mutations.

The combination treatment was previously available to people through the Cancer Drugs Fund and has now been approved for routine commissioning on the NHS. Around 3,000 people will be eligible for this treatment in England.

Previously, standard care for tumours that have no EGFR-positive or ALK-positive mutations depended on PD-L1 status.

The new draft guidance, annouced after MSD provided further data on long-term survival, means people with advanced non-squamous NSCLC will now be eligible for Keytruda with pemetrexed and platinum chemotherapy for up to two years, regardless of their PD-L1 status.

NICE noted clinical trial evidence that suggests that patients live longer when treated with the Keytruda combination treatment compared with standard chemotherapy.

However, there was no change in overall survival in patients with a PD-L1 positive tumour with a score of 50% or more when compared to those treated with Keytruda monotherapy, which is standard care for this patient group.

Meindert Boysen, director of the NICE Centre for Health Technology Evaluation, said: “Through the Cancer Drugs Fund, pembrolizumab with pemetrexed and platinum chemotherapy has shown the potential to extend the lives of thousands of individuals, and we are pleased to now be able to recommend the treatment routinely.”

“With the new draft guidance, patients meeting the specifications will now be eligible to receive pembrolizumab with pemetrexed and platinum chemotherapy for two years, or until their disease progresses within this period.”

David Long, oncology business development director of MSD, known as Merck & Co in the US and Canada, said: “This is doubly significant at a time when we know, due to the impact of COVID-19 on patient presentation, the system is seeing an increase in the diagnosis of later stage cancers - especially in lung cancer. It is therefore all the more important that clinicians have the best choices available for their patients.”