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NICE recommends afatinib for treatment of lung cancer

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The National Institute for Health and Care Excellence (NICE) in the UK has issued its final health technology appraisal recommending afatinib as a first-line treatment option for patients with advanced or metastatic non-small cell lung cancer (NSCLC).

Afatinib is a targeted treatment for NSCLC known as an epidermal growth factor receptor (EGFR) TK inhibitor.

Boehringer Ingelheim is currently developing afatinib (Giotrif) as the first oncology treatment for lung cancer patients in the UK

NHS England has recommended that afatinib is reimbursed at day zero, rather than after the standard 90 day implementation period, which will allow patients with lung cancer to have immediate access to afatinib with a prescription.

"Funding will ensure that patients living with EGFR mutation positive advanced non-small cell lung cancer can benefit from first-line treatment with afatinib without delay."

Boehringer Ingelheim UK and Ireland managing director Zinta Krumins said the company hopes this will standardise access to afatinib for patients in England following last month's acceptance in Scotland.

"It is now the responsibility of the NHS in England to provide funding," Krumins said. "This will ensure that patients living with EGFR mutation positive advanced non-small cell lung cancer can benefit from first-line treatment with afatinib without delay."

In the UK, around 43,500 people are diagnosed with lung cancer and there are an estimated 35,000 deaths each year, which is more than breast cancer and prostate cancer combined.

The new, once-daily, tablet afatinib targets the entire ErbB family of receptors, which are known to play a major role in the growth of cancer cells.

Afatinib works by blocking the signal pathways, helping to slow the growth and spread of tumours.

Data submitted to NICE included the major studies LUX-Lung 3 and LUX-Lung 6 carrie dout in EGFR mutation positive patients with advanced lung cancer.

In both trials, patients who received afatinib, lived for longer without any growth in their tumour (known as progression free survival, PFS) compared with chemotherapy.

LUX-Lung 3, the Phase III trial in patients with EGFR mutation positive advanced lung cancer, demonstrated that patients taking afatinib as a first line treatment lived for an average of 11.1 months without their tumour growing (PFS) versus 6.9 months for those treated with pemetrexed/cisplatin.

NICE chief executive Sir Andrew Dillon said this is the third targeted treatment that the institute has recommended for people with this form of lung cancer.

"NICE was able to publish this final guidance quickly, in just over 3 months since the committee first met to discuss the treatment," Dillon said.

"As afatinib was recommended in line with its licenced indication, our process allows us to exclude the consultation stage of the appraisal to speed-up access."

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