In what has been described as “great news” by a patients’ group, Tucatinib is to be accepted for use within NHS Scotland for those patients with an advanced and aggressive type of breast cancer.
The HER2-positive cancer generally grows and spreads much faster than others, accounting for around one fifth of the 4,700 annual breast cancer cases diagnosed each year.
The new drug is the first licensed in the UK to extend overall survival among patients who have already had two rounds of targeted treatments. It is also hoped the drug will reduce the need for radiotherapy or surgery among patients whose cancer has spread to the brain.
Dr David Cameron, professor of oncology at the University of Edinburgh, and a member of the steering committee for the HER2CLIMB registrational study, said the decision would “change the treatment landscape” for advanced HER2-positive breast cancer in Scotland.
He said: “For the first time, we have a targeted, fully-funded treatment option for HER2-positive patients with advanced or metastatic disease that can significantly extend survival, in those with brain metastases where it can also reduce the risk of further tumours developing.
“This is potentially a game-changing treatment for the many patients who desperately need it.”
The decision was also welcomed by Lesley Stephen from Edinburgh, who was diagnosed with HER2-positive breast cancer in 2014.
Although the cancer spread to her liver, lungs, bones, and brain, the 56-year-old has been taking a trial drug of a similar class to Tucatinib, which she said had prolonged her life.
“Being able to access this drug will help any patient fearing or living with brain mets, and it will give those patients a much kinder treatment option than either radiotherapy or surgery,” she explained.
“I have been able to live a fairly normal life with my family for over six years, and been able to experience some of those milestones that I thought cancer had taken away – seeing my two eldest go to university and my youngest go to secondary school. It's been a miracle lifesaver for me.”
The HER2CLIMB study found Tucatinib, in combination with two other drugs, reduced the risk of death by just over a third (34 per cent), compared with one of the drugs used in isolation.
Jo Taylor, founder of MET UP UK, a patient advocacy group, said: “We know up to 50 per cent of patients with metastatic HER2-positive breast cancer go on to develop brain metastases, but until now there have been limited targeted drug treatments funded by the NHS for these patients.
“This means there is unmet need in this area for patients with metastatic breast cancer to be treated effectively, especially in difficult-to-treat patients with brain metastases. It is great news that patients in Scotland now have access to treatment with Tucatinib.”
In October last year, the National Institute for Health and Care Excellence (NICE) announced its provisional decision to not recommend tucatinib with other drugs for treating HER2-positive breast cancer after at least two prior anti-HER2 treatments on the NHS in England.
It said the estimates for the treatment are higher than what it considers a cost-effective use of NHS resources.