Astellas’ Xtandi (enzalutamide)
The National Institute for Health and Care Excellence (NICE) today backed two new cancer treatments for NHS use in England and Wales.
The guidance recommends a new skin cancer indication for Bristol-Myers Squibb’s Yervoy (ipilimumab), while Astellas’s Xtandi (enzalutamide) receives its first NICE recommendation for use in prostate cancer.
Yervoy is already recommended for NHS use as a second-line treatment for people with advanced malignant melanoma but this new guidance pushes the drug further up the treatment pathway as a first-line treatment if the tumour cannot be removed or the cancer has spread to other parts of the body.
This means the drug can be made available to cancer patients prior to chemotherapy.
As with the previous NICE guidance for Yervoy, the recommendation is dependent on BMS providing the drug at a discount through a patient access scheme.
Yervoy has performed well for BMS since launching in 2011, with sales of just under $1bn for 2013. Gaining extra indications is crucial for BMS, however, as more advanced rivals in melanoma hit or near the market, including GSK’s MEK inhibitor Mekinist (trametinib) and Merck & Co’s immunotherapy pembrolizumab.
BMS has its own next generation melanoma treatment in the works in the form of anti-PD1 inhibitor nivolumab. The drug was recently approved in Japan under the name Opdivo.
Xtandi recommended to treat prostate cancer
NICE’s second recommendation was for the use of Astellas’ Xtandi (enzalutamide) in the treatment of people with prostate cancer that has spread to other parts of the body.
These patients must also have been treated with the cytotoxic drug docetaxel and Astellas must provide Xtandi through a patient access scheme.
The decision follows a troubled path through NICE for Xtandi, which earlier this year was recommended in draft guidance that heavily restricted the use of the drug.
However, following consultation with Astellas and other parties, these restrictions were overturned.
Prof Carole Longson, director of the centre for health technology evaluation at NICE, said: “Both cancer treatments are recommended on the basis that the manufacturers provide them to the NHS with a patient access scheme, where there is a discount on the price of the drug.
“We are also very pleased that the manufacturers have worked with us to provide more evidence so that we are able to recommend both treatments.”