{"id":28458,"date":"2022-11-14T11:48:03","date_gmt":"2022-11-14T11:48:03","guid":{"rendered":"https:\/\/news.cancerresearchuk.org\/?p=24888"},"modified":"2024-11-03T15:13:12","modified_gmt":"2024-11-03T15:13:12","slug":"nice-recommends-pembrolizumab-for-1600-more-people-with-breast-cancer","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/nice-recommends-pembrolizumab-for-1600-more-people-with-breast-cancer\/","title":{"rendered":"NICE recommends pembrolizumab for 1,600 more people with breast cancer"},"content":{"rendered":"
\"BreastA breast cancer cell seen through an electron microscope. <\/p>

” data-image-caption data-medium-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2021\/05\/cell-breast-cancer_2017-3-300×168.jpg” data-large-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2021\/05\/cell-breast-cancer_2017-3.jpg”><\/p>

A breast cancer cell seen through an electron microscope. <\/span> Credit: Leicester Royal Infirmary EM Department <\/span><\/p>\n<\/div>\n

The National Institute for Health and Care Excellence (NICE) has recommended the use of the immunotherapy drug <\/span>pembrolizumab<\/span><\/a> (Keytruda) as an option for some people with early <\/span>triple negative breast cancer<\/span><\/a> (TNBC) in England and Wales.<\/span> <\/span><\/p>\n

The NHS has also negotiated a new discount on the drug from its manufacturer, MSD.<\/span> <\/span><\/p>\n

According to NICE estimates, this <\/span>new guidance<\/span><\/a> means that, in England alone, approximately 1,600 more people affected by this aggressive form of the disease should now be eligible for immunotherapy every year. <\/span> <\/span><\/p>\n

Pembrolizumab was previously available for a small group of people with advanced TNBC that had spread or couldn\u2019t be surgically removed. <\/span> <\/span><\/p>\n

NICE has now recommended that the drug should also be made available for people affected by early TNBC at high risk of recurrence or locally advanced TNBC that hasn\u2019t spread elsewhere in the body. It will be given with chemotherapy as a way of reducing the size of a tumour before surgery and on its own as a post-surgery treatment. <\/span> <\/span><\/p>\n

\n
\n

It will give hope to those who are diagnosed, and prevent the cancer from progressing, allowing people to live normal, healthy, lives.<\/p>\n<\/div>\n

Amanda Pritchard, NHS chief executive<\/cite><\/p>\n<\/blockquote>\n

An effective new treatment option<\/span> <\/span><\/h2>\n

Clinical trials have shown that this combined approach can reduce the chance of TNBC growing or progressing by 37%<\/a> compared to chemotherapy alone. <\/span><\/p>\n

It also increases the likelihood that a cancer will completely respond to treatment, lowering the risk of it returning in future, and lessens the need for <\/span>mastectomies<\/span><\/a>, surgeries that fully remove people\u2019s breasts. <\/span> <\/span><\/p>\n

A 3D model of pembrolizumab\u2019s molecular structure<\/p>

” data-medium-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure.jpg” data-large-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure.jpg” class=”wp-image-24890 size-full” src=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure.jpg” alt=”A 3D molecular model of pembrolizumab” width=”200″ height=”200″ srcset=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure.jpg 200w, https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure-150×150.jpg 150w, https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/Pembrolizumab-molecular-structure-96×96.jpg 96w” sizes=”(max-width: 200px) 100vw, 200px”><\/p>

A 3D model of pembrolizumab\u2019s molecular structure. Kateryna Kon\/Shutterstock.com<\/a> <\/span><\/p>\n<\/div>\n

Clinical experts told the NICE committee that less invasive breast-conserving surgery supports a better quality of life. <\/span> <\/span><\/p>\n

\u201cThis is good news for people affected by early triple negative breast cancer,\u201d said Michelle Mitchell, Cancer Research UK\u2019s chief executive. \u201cThis type of breast cancer has a high risk of recurring after treatment, which can cause real anxiety for patients.<\/span> <\/span><\/p>\n

\u201cClinical trial evidence has shown that pembrolizumab with chemotherapy before surgery \u2013 and pembrolizumab on its own after surgery \u2013 can not only extend the time before the cancer comes back, but also increase the chance that the cancer disappears.\u201d<\/span> <\/span><\/p>\n

What is triple negative breast cancer?<\/span> <\/span><\/h2>\n

TNBC is a less common form of breast cancer. Around 8,000 people in the UK are diagnosed with it every year.<\/span> It only makes up around 15% of breast cancer cases, although it disproportionately affects women under 40 and those from Black backgrounds.<\/span> <\/span><\/p>\n

Unlike most other breast cancers, TNBC cells don\u2019t have receptors for either of the two main female sex hormones (oestrogen and progesterone) or a protein called HER2.<\/span> <\/span><\/p>\n

That means TNBC doesn\u2019t respond to the hormone treatments and targeted drugs that are part of the standard of care for most other breast cancers.<\/span> <\/span><\/p>\n

Moreover, TNBC is often more aggressive than other types of breast cancer. It\u2019s also more likely to return after treatment.<\/span> <\/span><\/p>\n

As a result, despite its relative rarity, TNBC causes around 25% of breast cancer deaths. <\/span> <\/span><\/p>\n

There have been limited improvements to treatment options for early and locally advanced TNBC in recent years. Before this recommendation, people affected by it usually had chemotherapy and then surgery.<\/span> <\/span><\/p>\n

The NICE committee concluded that, given the pressing need for treatments, adding pembrolizumab before and after surgery would be welcomed as a potential \u201clifeline\u201d for people affected by the disease. <\/span> <\/span><\/p>\n

The benefits of pembrolizumab<\/span> <\/span><\/h2>\n
Pembrolizumab helps t cells like this attack cancer cells<\/p>

” data-medium-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary.jpg” data-large-file=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary.jpg” loading=”lazy” class=”wp-image-24893 size-full” src=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary.jpg” alt=”3D illustration of a T cell” width=”200″ height=”200″ srcset=”https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary.jpg 200w, https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary-150×150.jpg 150w, https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/11\/t-cell-secondary-96×96.jpg 96w” sizes=”(max-width: 200px) 100vw, 200px”><\/p>

Pembrolizumab helps immune cells like this one attack cancer. fusebulb\/Shutterstock.com <\/span><\/p>\n<\/div>\n

The decision was made based on interim results from the KEYNOTE-522 trial, which is scheduled to finish in 2025. When it was evaluated by NICE, the study showed that combining pembrolizumab with chemotherapy made it more likely that early-stage TNBC would completely respond to treatment.<\/span><\/p>\n

In this study, people were said to have experienced a \u2018complete response\u2019 if treatment removed all signs of cancer from their breast tissue and surrounding lymph nodes. This is an important measure for TNBC because it lowers the need for invasive surgery and often leads to better long-term outcomes.<\/span> <\/span><\/p>\n

The trial also showed that adding pembrolizumab to chemotherapy before surgery, then continuing with pembrolizumab alone after surgery increases the time before TNBC recurs or progresses.<\/span> <\/span><\/p>\n

Together, these findings suggest that, over a longer period of time, adding pembrolizumab to standard care would also make a difference to how long people live after receiving treatment. <\/span> <\/span><\/p>\n

Although adding pembrolizumab to chemotherapy also increases the risk of serious side-effects, NICE concluded that this is outweighed by the drug\u2019s benefits. As a patient expert told the committee, that\u2019s especially important because TNBC is associated with younger people, who may have young families.<\/span> <\/span><\/p>\n

\u201cThis is a hugely significant moment for women,\u201d said Amanda Pritchard, the chief executive of the NHS. \u201cThe NHS has struck a new deal to roll out a potentially life-saving drug for patients suffering with the most aggressive form of breast cancer that has been traditionally very difficult to treat. <\/span> <\/span><\/p>\n

\u201cIt will give hope to those who are diagnosed, and prevent the cancer from progressing, allowing people to live normal, healthy, lives.\u201d<\/span> <\/span><\/p>\n

How does pembrolizumab work?<\/span> <\/span><\/h2>\n

Pembrolizumab is a type of immunotherapy called a <\/span>checkpoint inhibitor<\/span><\/a>. It\u2019s given by a drip into a vein and works by blocking a specific protein on immune cells that can stop them from attacking cancers. <\/span> <\/span><\/p>\n

NICE recommended its first checkpoint inhibitor for people affected by triple negative breast cancer in 2020.<\/span><\/p>\n

In that case, <\/span>atezolizumab<\/span><\/a> (Tecentriq) was <\/span>recommended with chemotherapy as a first treatment<\/span><\/a> for people whose cancer has spread or returned and can\u2019t be surgically removed. At the time, that group included around 600 people.<\/span> <\/span><\/p>\n

Then, in June this year, NICE recommended pembrolizumab for a smaller group of people in the same position who aren\u2019t eligible for treatment involving atezolizumab.<\/span> <\/span><\/p>\n

The main difference between pembrolizumab and atezolizumab is in the way they activate the immune system. Atezolizumab blocks a protein that cancer cells use to disarm immune cells. Pembrolizumab, meanwhile, stops immune cells from being disarmed.<\/span> <\/span><\/p>\n

The latest guidance for pembrolizumab makes immune checkpoint therapy available for a much larger group of people with earlier stage TNBC across England and Wales. NICE decisions are also usually adopted in Northern Ireland. <\/span> <\/span><\/p>\n

More on this topic<\/h3>\n<\/p>\n

Source<\/a><\/p>","protected":false},"excerpt":{"rendered":"

A 3D model of pembrolizumab\u2019s molecular structure. Kateryna Kon\/Shutterstock.com Clinical experts told the NICE committee that less invasive breast-conserving surgery supports a better quality of life. \u201cThis is good news for people affected by early triple negative breast cancer,\u201d said Michelle Mitchell, Cancer Research UK\u2019s chief executive. \u201cThis type of breast cancer has a high […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-28458","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28458","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=28458"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28458\/revisions"}],"predecessor-version":[{"id":43152,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28458\/revisions\/43152"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=28458"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=28458"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=28458"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}