More than 1,500 people a year with an aggressive form of stomach cancer are set to receive a new treatment available on the NHS, after NICE recommended durvalumab - the first immunotherapy for people with this form of cancer.
The targeted treatment helps people live longer and can help prevent the disease from returning. Durvalumab, also known as Imfinzi and made by AstraZeneca, is recommended for adults whose stomach (gastric and gastro-oesophageal junction) cancer has not spread extensively and can be removed through surgery.
The drug received its marketing authorisation from the Medicines and Healthcare products Regulatory Agency (MHRA) very recently and NICE’s guidance was produced using a simpler assessment process, meaning patients will get access to the treatment faster than if the standard process had been used.
Gastric and gastro-oesophageal junction cancer - where tumours form in the stomach or where it meets the oesophagus - is frequently diagnosed at an advanced stage. Even when surgery is possible, the cancer returns in many patients, and only around half of people survive five years after diagnosis.
Clinical trial evidence shows that durvalumab plus FLOT chemotherapy (fluorouracil, leucovorin, oxaliplatin and docetaxel) before and after surgery, then on its own after surgery, increases how long people have before their cancer gets worse and how long they live compared with chemotherapy alone.
In one trial, people taking durvalumab had on average just over 40 months without their cancer getting worse, compared with just over 32 months for people taking chemotherapy alone. Of the 948 people who took durvalumab as part of the trial, 68.6% lived for three years compared with 61.9% taking the standard chemotherapy treatment. Patient and clinical experts told NICE that stomach cancer coming back after surgery is common, meaning the current long-term prognosis for patients is poor.
Durvalumab is given by intravenous infusion every four weeks. It works by blocking the PD-L1 protein, which cancer cells use to hide from the body's immune system. The drug allows the immune system to identify and attack cancer cells.
NICE applied its light-touch, streamlined process to its assessment of durvalumab, enabling a positive final draft to be made faster than under its usual process, without the need for a committee meeting.