Larotrectinib (also called Vitrakvi and made by Bayer), a new treatment for a range of cancers, can't be recommended for use in the NHS because at its current price, it doesn't have the potential to be cost-effective.
Another histology independent treatment, entrectinib (made by
Histology independent cancer drugs target all solid tumours with a certain genomic mutation, regardless of where the primary tumour is in the body. They are one of the three priority categories of early-stage focus for the Accelerated Access Collaborative, a cross-sector partnership aimed at accelerating access to transformative health technologies, of which NICE is one of the partners.
Both drugs offer a new option to patients, including for some rare types of cancer, where treatments are currently limited.
The draft guidance considers larotrectinib for treating advanced neurotrophic tyrosine receptor kinase (NTRK) fusion-positive solid tumours, in adults and children who have no satisfactory treatment options.
'Larotrectinib and entrectinib offer a major change in the treatment of NTRK fusion-positive solid tumours. The introduction of a new NHS Genomic Medicine Service is expected to support the uptake of these progressive therapies, testing tens of thousands of solid tumours solid tumours per year once it is fully established. These advances represent important steps in the NHS long-term plan, enabling eligible patients to be identified, and treated, quicker.
'We're hopeful that further data collection, coupled with responsible pricing from the companies, will lead to progressive, new treatments like these being available to patients. As a partner in the Accelerated Access Collaborative, NICE will do all it can to assist the company in providing the reassurances required to allow larotrectinib to be recommended for inclusion in the CDF.'
NTRK gene fusions are thought to drive tumour growth. Solid tumours with NTRK gene fusions occur in less than 1% of common tumours such as lung, colorectal and breast cancers. The mutation is much more common in certain rare cancers.
Around 600-700 people have solid tumours with NTRK gene fusions. A proportion of these people, who have no satisfactory treatment options, will be eligible for one of these therapies within the first year that they're available on the NHS.
There is no standard treatment for NTRK fusion-positive tumours, so current treatment is based on where in the body the cancer starts.
'In the meantime, preparation continues for the introduction of this next generation of therapies, including constructive conversations with
This draft guidance is currently open for consultation until the
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