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A life-extending injection for a fatal form of blood cancer will be available to around 350 patients per year in England, the NHS chief executive has announced.
The drug, which can extend the lives of patients with a recurring and incurable cancer of the bone marrow cells – known as multiple myeloma – by an average of nine months, has been given the green light for routine use by NICE after it was made available for a limited period through the Cancer Drugs Fund.
Multiple myeloma is a debilitating cancer that affects the bone marrow in several areas of the body, including the spine, skull, pelvis and ribs, causing sufferers to have weak and painful bones, unusual bleeding, fatigue and weight loss – as well as weakening their immune system, leading to recurrent infections.
Myeloma cannot be cured and treatment is usually about keeping the cancer at bay for as long as possible with the least side-effects from treatment.
This NHS treatment will be offered to patients with recurring multiple myeloma who have tried at least three other treatments will help multiple myeloma patients live longer lives whilst improving their quality of life. It also gives patients a greater chance of accessing further treatments that may help them live even longer, healthier lives.
The drug, called daratumumab, is a monoclonal antibody administered by a regular injection taking just five minutes and generally causes few side effects. It works by attaching to a protein on the cancer’s cells, signifying to the immune system to kill it.
NHS Chief Executive, Amanda Pritchard said: “This quick injection can have a real impact on the lives of patients and their families and so it is important news that it is now routinely available on the NHS.
“The drug will offer a ray of light to hundreds of people each year who have had limited success with other treatments for this devastating, advanced blood cancer.
“It is also the latest in a long list of cutting-edge, targeted cancer treatments that the NHS has secured routine access to through the Cancer Drugs Fund, making it good value for taxpayers too.
“The NHS has continued to prioritise cancer care throughout the pandemic and I urge anyone with concerns, to come forward and get checked”.
Health and Social Care Secretary Sajid Javid said: “It is great the NHS will begin routinely administering daratumumab to blood cancer patients – this life-extending drug is another example of an innovative treatment being rolled out on the NHS, marking a significant stride in our mission to make the country’s cancer care the best in Europe.
“The government is placing huge emphasis on research into the best possible care and treatment for cancer as part of the 10-Year Cancer Plan, as well as improving early diagnosis so treatment can be more effective”.
The NHS Long Term Plan is committed to providing the latest cutting-edge treatments and therapies for patients, and the Cancer Drugs Fund provides faster access to promising cancer treatments on the health service in England.
Jimmie Archer, 72 from Luton, has been treated for myeloma since 2011. He has had a number of different treatments, including stem cell transplant and starting having daratumuab shortly before the pandemic hit.
He said: “They have tried different treatments for me and this is the only one that has worked. With the other treatments, my numbers would start creeping up, but with this one, they stay down.
“My treatment is given in the Macmillan Cancer Centre. It took six hours initially as they had to get me used to it gradually. Now I don’t spend long at the hospital at all. It is just an injection. I have responded really well and my levels are now too low to quantify. It is a lot easier with this treatment. Thank god I responded. I feel a lot better now. It is the best drug I have had so far”.
Professor Kwee Yong, UCLH clinical and academic lead in multiple myeloma said: “Daratumumab is a first-in-class monoclonal antibody for treating multiple myeloma. We have been treating people with daratumumab through the NHSE Cancer Drugs Fund and we have seen the difference it makes to our patients. People on Daratumumab therapy have minimal side effects and can resume their normal activities, enjoying life with family and friends, and even back to work.
“We are pleased it will now be routinely available and patients can receive a drug which can extend their life while we use the time to identify further treatments.”
Around 5,000 people are diagnosed with multiple myeloma in the UK each year. It more frequently affects men, people aged over 60 and is twice as likely to be developed by Black or African ethnicities than White or Asian groups.
The NHS initially made daratumumab available through the Cancer Drugs Fund in 2018, allowing patients to access to new treatments while further data was collected on its clinical and cost effectiveness – supporting NICE in making a final recommendation around its routine use in the NHS.
Evidence to date shows that the drug is clinically effective at a price that is affordable for taxpayers, and this will continue to be evaluated to determine if it could be administered an earlier stage of a patient’s treatment.
Helen Knight, programme director in the NICE Centre for Health Technology Evaluation says: “Based on real world evidence collected from over 2000 NHS patients while daratumumab was available via the Cancer Drugs Fund, together with further trial data, the independent appraisal committee agreed that daratumumab increased how long people with relapsed and refractory multiple myeloma lived compared with standard care.
“Having first recommended daratumumab through the Cancer Drugs Fund in December 2017, we are pleased that the latest evidence means this drug will now be available for routine use in people with this very serious form of cancer.”
Shelagh McKinlay, Acting Director of Research and Patient Advocacy at Myeloma UK, said: “We are delighted that daratumumab monotherapy has been made routinely available through the NHS in England. Going down the Cancer Drugs Fund route allowed the treatment to be conditionally approved and given to patients sooner while the necessary data was being gathered. This clearly shows how patients can benefit from the CDF and helps pave the way for many more life-changing treatments to be rolled out earlier to those who need them the most.
“Living with myeloma is a constant race against the clock, and with every relapse treatment options become more and more limited. That’s why delivering new treatments as soon as possible makes a tremendous difference to patients’ quality of life and life expectancy”.
It is initially given to patients on a weekly basis, before being administered bi-weekly after the first two months, and then monthly after half a year.
Daratumumab is the latest in a series of commercial deals the NHS has agreed over the last year, securing innovative treatments for patients with spinal muscular atrophy, metachromatic leukodystrophy and the blood disorder, mastocytosis, while also extending access to a ‘miracle’ cystic fibrosis treatment, (Kaftrio).
Amanda Cunnington, Director of Patient Access, Janssen-Cilag Limited said: “Today’s decision to recommend daratumumab for routine commissioning on the NHS is welcome news. This positive FAD demonstrates how through close collaboration, there is opportunity to work with the UK system to provide greater certainties on medicines.”