NICE, the National Institute for Health and Care Excellence, has published draft guidance recommending thyroid cancer treatments cabozantinib (Cometriq, Ipsen), and sorafenib (Nexavar, Bayer) to come off the Cancer Drugs Fund and into routine NHS use. NICE has also recommended that lenvatinib (Lenvima, Eisai), should be routinely available.
It is estimated by the companies that approximately 1300 people could benefit from these treatments over the next five years.
NICE states that the recommendations have been made in two appraisals. In one, cabozantinib is now recommended as an option for treating medullary thyroid cancer (MTC) that cannot be operated on or has spread around the body. MTC is a rare type of thyroid cancer with around 80 people diagnosed with it each year in England.
Cabozantinib is a targeted therapy which works by blocking certain proteins on cancer cells, stopping them growing and dividing.
It is estimated from the clinical trial data, that the drug gives patients an extra 5.5 months of life by slowing down the growth of the disease.
Cabozantinib is currently one of the only two treatment options for patients with this type of thyroid cancer.
In the other appraisal, lenvatinib and sorafenib are now recommended as options for differentiated thyroid cancers that have continued to grow or spread around the body after surgery and radioactive iodine therapy.
Differentiated thyroid cancers are the most common type of thyroid cancer and affect around 1800 to 2790 people each year in England. Approximately 200 of those people have tumours that continue to grow after radioactive iodine therapy.
Both drugs work by blocking certain proteins in cancer cells to shrink the tumours, extending the length of time people live with this type of thyroid cancer.
Mirella Marlow, acting director of the NICE centre for health technology evaluation, said: “Treatment options for these types of thyroid cancer are limited, so it is important that we are able to give patients much needed access to alternatives to best supportive care at this stage of their disease. These drugs will give patients extra time, as well as improving their quality of life. ”
There are around 3400 cases of newly diagnosed thyroid cancer in the UK each year. Over the last decade, thyroid cancer rates have more than doubled in the UK.
The companies have an agreement with either NHS England or the Department of Health and Social Care which will provide a simple discount to the list price of the drugs. These are confidential discounts.
