NICE Approval of New Drug Treatment for Mesothelioma
By Helen Childs. 6th September 2022
Pleural mesothelioma is a cancer of the cells surrounding the lungs. Symptoms include breathlessness, chest pain, fatigue, lethargy, weight loss and cough. Mesothelioma is treatable but incurable and progresses quickly and has a poor prognosis, with just 8-10% of patients surviving for three years.
The vast majority of mesothelioma cases are linked to exposure to asbestos in a work environment, where it was used for it's heat resistance qualities. More than 2,500 people diagnosed with the cancer each year in the UK, with first symptoms normally appearing at least 30 years after asbestos.
Until recently, approved treatments for pleural mesothelioma have been limited to chemotherapy, which has moderate survival benefit and often has poor outcomes.
In July 2022, a new mesothelioma treatment was approved by NICE of dual immunotherapy drugs - Ipilimumab and Nivolumab for mesothelioma patients. This immunotherapy treatment will now be available on The NHS for those with both pleural or peritoneal mesothelioma and offers what is hoped to be a less toxic drugs regime than chemotherapy.
In its published recommendations, NICE also noted that although mesothelioma was once a disease of men in industry, it is also now being seen in women and younger people. It is the first new mesothelioma drug to be approved by the NHS in fourteen years, and offers mesothelioma patients the hope of improved survival rate as illustrated by the Checkmate 743 Phase 3 trial.
Checkmate 743 Phase 3 trial for mesothelioma drugs
This trial was run at 103 hospitals across 21 countries. Eligible participants were over the age of 17, with previously untreated malignant pleural mesothelioma. They were randomly assigned nivolumab plus ipilimumab for up to 2 years, or platinum plus pemetrexed chemotherapy once every 3 weeks for up to six cycles. The primary endpoint was overall survival among all participants randomly assigned to treatment.
Most of the 713 patients were male with an average age of 69 years. Around 30 months later - in April 2020 - it was found that nivolumab plus ipilimumab significantly extended overall survival versus chemotherapy. Median overall survival of 18.1 months with immunotherapy vs 14.1 months with chemotherapy. The 2 year overall survival rates were 41% in the immunotherapy group and 27% in the chemotherapy group.
The new drugs will be delivered intravenously to patients in 30-minute sessions every three weeks (nivolumab) and every six weeks (ipillmumab) for up to two years.
Immunotherapy will continue to be available as a second line of treatment for those who commenced chemotherapy treatment before 14 July 2022.
Our lead solicitor Helen Childs comments:
“ Obviously the decision of what drug regime is most appropriate is one that is made by the patient and their clinical team. It is really heartening to see that another line of treatment is now available for those with mesothelioma. However those to wish to access bespoke medical treatment regime should still be able to do so within the context of a normal civil legal claim. ”
Professor Peter Johnson, National Clinical Director for Cancer for the NHS in England said:
“ The NHS is delighted that this new drug combination will now be available for patients with this aggressive type of cancer, giving them more precious time with their families and friends . . . We know that unfortunately many people are likely to develop mesothelioma as the result of previous exposure to asbestos, but up to now we have had limited options for their treatment. This makes these new immunotherapy drugs even more vital and reinforces our commitment to using the latest treatments to improve the life chances of our patients. ”
We are here to answer any questions you may have. Please contact us on the Freephone number below and ask for Kathy Cooke or Warren Miller
Source
1. First-line nivolumab plus ipilimumab in unresectable malignant pleural mesothelioma (CheckMate 743): a multicentre, randomised, open-label, phase 3 trial
https://www.thelancet.com/article/S0140-6736(20)32714-8/fulltext
2. Breakthrough treatment to boost life chances for hundreds of people with respiratory cancer
https://www.england.nhs.uk/2022/07/breakthrough-treatment-to-boost-life-chances-for-hundreds
Author
Helen Childs
Lead Solicitor
Helen is our lead solicitor and a partner at Royds Withy King Solicitors. Helen is recognised as a Leading Lawyer by the Legal 500, where she is described as an exceptional partner with a huge capacity for work and an unerring willingness to fight for her clients and an excellent knowledge of asbestos litigation.. Read more >
