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NHS Rolls Out Combination Therapy Women with Endometrial Cancer

Hundreds of women with advanced uterine cancer in England will be offered a new treatment option from today, NHS England announced. The combination therapy was initially rejected in draft guidance by NICE on the grounds of cost-effectiveness but is now being offered thanks to a new agreement with pharmaceutical companies that makes the treatment more affordable.

Endometrial carcinoma is the most common type of uterine cancer, and while it often had a better prognosis than other uterine cancers if diagnosed early, advanced, or recurrent endometrial carcinoma can be challenging to treat with short survival times, said NHS England.

There are around 9700 new uterine cancer cases in the UK every year – 27 every day – explained Cancer Research UK, with the disease being the fourth most common cancer in females in the UK. Moreover, there are around 2500 uterine cancer deaths in the UK every year – nearly 7 every day – and over the last decade, uterine cancer mortality rates have increased by around a quarter (24%) in females in the UK, alerted the charity.

Professor Peter Johnson, NHS national cancer director, underlined thatmost uterine cancers can be "cured if we catch them early". However, he explained, for the women whose cancers are at a more advanced stage, it was "great news" that an effective treatment was available for them that can "help them to live longer and better".

Significantly Longer Overall Survival

NHS England celebrated having negotiated "landmark commercial deals" for the two drugs from different manufacturers, which would be used in combination to treat advanced endometrial cancer, with up to 750 women each year set to benefit.

Used together, the two drugs – pembrolizumab (Keytruda, MSD) and lenvatinib (Lenvima, Eisai UK) – had been shown in research to double the time taken for cancer to progress compared with the existing chemotherapy treatment, from just over 3 1/2 months to more than 7 months, a spokesperson for NHS England said.

In the trial, overall survival was also significantly longer for patients taking the combination therapy compared to existing chemotherapy treatments. Those receiving chemotherapy survived just under 12 months, whilst those who received the drug combination survived almost 19 months.

Limited Treatment Options for Advanced Stages

NHS England explained that the drug combination will be offered to all eligible women who have previously received treatment for advanced or recurrent endometrial cancer.

Pembrolizumab is delivered intravenously every 3 or 6 weeks, while lenvatinib is taken once per day. An additional benefit of the newly approved drug combination is that, unlike with chemotherapy, there was a far less significant risk of hair loss" as a side effect.

Director of medicines evaluation at NICE, Helen Knight, said: "There are currently few treatments for advanced endometrial cancer so this combination therapy is an important addition, providing women with the hope of valuable additional time with their loved ones."