NICE delivers more good news for cervical cancer patients

Hundreds of women with aggressive cervical cancer are to be offered MSD's Keytruda on the NHS in England, in the second expansion of immunotherapy for the disease in consecutive days.

Reimbursement authority NICE has said that PD-1 inhibitor Keytruda (pembrolizumab) given alongside chemoradiotherapy is now a frontline treatment option for women with stage 3 or 4 locally-advanced cervical cancer (LACC) that has not yet metastasised to distant parts of the body. The NHS has estimated that around 270 women will be eligible for the new treatment per year.

The final draft guidance comes a day after Regeneron's PD-1 inhibitor Libtayo (cemiplimab) was recommended by NICE for the treatment of women with recurrent or metastatic cervical cancer that has progressed on or after platinum-based chemotherapy, and who have not previously had immunotherapy.

The decision to back Keytruda for LACC – the first recommendation for an immunotherapy for LACC in England – comes on the back of the KEYNOTE-A18 trial, which showed that adding the PD-1 inhibitor to standard chemoradiotherapy helped keep cancer at bay for longer and improved survival rates.

Two years after starting the treatment, 68% of patients were still living without their cancer progressing, compared with 57% for those receiving chemoradiotherapy alone, with overall survival at three years coming in at 82.6% and 74.8%, respectively.

NICE's recommendation covers both the intravenous and recently launched subcutaneous versions of Keytruda.

"This is great news for women facing a diagnosis of aggressive cervical cancer – and represents one of the biggest improvements in treatment for this disease in recent years," said Prof Peter Johnson, NHS National Clinical Director for Cancer.

"We're delighted it will be available for patients on the NHS, as it could help hundreds more women survive and stay cancer-free in the long-term."

Despite the rollout of an HPV vaccination campaign in the UK a few years ago, which has had a dramatic impact on cervical cancer rates in young women, it remains the 14th most common cancer affecting women in the UK, with around 3,300 new cases each year, according to Cancer Research UK. It is thought that HPV, which is spread through close skin-to-skin contact, is responsible for 99% of cases.

Louise Broadbelt, 55, from Surrey, was diagnosed with stage 3 LACC aged 50 and accessed Keytruda and chemoradiotherapy as part of the KEYNOTE-A18 trial while being treated at The Royal Marsden Hospital.

"Nothing can prepare you for being diagnosed with cancer. All you want to hear is you will get the best possible treatment and have hope," she said. "I feel incredibly blessed and lucky that I was offered to participate in the trial and that I am still here today and the results may help others."