Hundreds of women with advanced cervical cancer in England are set to benefit from a new NHS treatment that could significantly improve survival rates and help keep the disease from returning.
The immunotherapy drug pembrolizumab has been approved for NHS use in combination with standard chemoradiotherapy for patients with stages three and four locally advanced cervical cancer.
The treatment is aimed at women whose cancer has spread beyond the cervix into nearby tissue, such as the pelvic wall, but has not spread to other parts of the body.
The National Institute for Health and Care Excellence (NICE) has approved the treatment following a commercial agreement between NHS England and the manufacturer, MSD. Eligible patients will receive immediate access through the NHS Cancer Drugs Fund.
Clinical trial results showed that combining pembrolizumab with chemoradiotherapy improved outcomes compared with standard treatment alone. Two years after starting treatment, 68 per cent of patients receiving the combination therapy were still alive without their cancer progressing, compared with 57 per cent of those treated with chemoradiotherapy alone.
After three years, 82.6 per cent of patients receiving pembrolizumab alongside chemoradiotherapy were still alive, compared with 74.8 per cent of those receiving standard treatment.
Pembrolizumab works by blocking a protein known as PD-1, allowing the body’s immune system to recognise and attack cancer cells more effectively. Experts have described the treatment as helping to “take the handbrake off” the immune system.
The drug is administered either every three or six weeks, either by intravenous infusion or through a recently introduced injectable version that can be given in around one minute.
The NHS estimates that around 550 women in England will be eligible for the treatment over the next two years, equating to around 270 patients annually.
Professor Peter Johnson, NHS National Clinical Director for Cancer, said:
“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.
“Combining this immunotherapy with existing treatment has had very positive effect for patients in trials, helping the body’s immune system to target cancer more effectively.
“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.”
One of the patients to benefit from the treatment said:
“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.
“I’m very grateful that I was offered the chance to go on the pembrolizumab clinical trial in 2021. I feel incredibly blessed and lucky that I was offered to participate in the trial and that I am still here today.”
The KEYNOTE-A18 international clinical trial included patients treated at both The Royal Marsden NHS Foundation Trust and the Royal Devon and Exeter NHS Foundation Trust.
According to Cancer Research UK, cervical cancer is the 14th most common cancer affecting women in the UK, with around 3,300 people diagnosed each year.
The approval follows other recent advances in cervical cancer treatment, including the introduction of cemiplimab for recurrent or metastatic disease after chemotherapy. It also comes after research found that children vaccinated against HPV at the age of 12 or 13 have an almost zero risk of dying from cervical cancer before the age of 30.
Public Health Minister Sharon Hodgson said:
“This is a significant step forward for women facing one of the most aggressive forms of cervical cancer. Making pembrolizumab available on the NHS will give more patients access to a treatment that could help them live longer and, for some, achieve cancer-free lives.
“Thanks to the NHS, NICE and our partnership with industry, women in England will be among the first to benefit, ensuring the latest advances in cancer care reach those who need them most, as quickly as possible.”
Lyndsy Ambler, Cancer Research UK’s senior strategic evidence manager, said:
“Adding immunotherapy to standard cancer treatment could improve people’s chances of survival, so it’s encouraging that pembrolizumab is being made available for some people with locally advanced cervical cancer through the Cancer Drugs Fund. This decision may also allow some patients to access the drug earlier in their treatment than previously.”
John McNeill, Oncology Business Unit Director at MSD in the UK, said:
“We welcome today’s recommendation from NICE, which is an important step forward for women living with locally advanced cervical cancer.
“This is a cancer which disproportionately impacts women from underserved backgrounds and where there has long been an unmet need. Today’s decision represents a meaningful development for these patients, who may benefit from additional treatment options.”
