New drug treatment approved for asbestos-related cancer patients in England and Wales

Mesothelioma UK, the national asbestos-related cancer charity, has welcomed the approval of the first immunotherapy treatment for 14 years to be made available by the NHS for mesothelioma patients in England and Wales.

The National Institute for Health and Care Excellence (NICE) has issued a Final Appraisal Document (FAD) recommending the combination of nivolumab plus ipilimumab for the first-line treatment of adult patients with unresectable malignant pleural mesothelioma (MPM) in England and Wales. Within the FAD, the NICE committee also recommended extending the guidance of nivolumab plus ipilimumab to treat rarer forms of mesothelioma found in the pericardium and peritoneum (the lining of the heart and abdomen respectively).

Mesothelioma is a cancer related to exposure to asbestos and predominantly affects the lining of the lungs. It is often diagnosed late, giving patients an average of less than a year’s survival without treatment. The UK has the highest incidence of the disease in the world with around 2,700 people diagnosed each year.

The nivolumab and ipilimumab combined immunotherapy treatment has been proven in CheckMate -743, a randomised, open-label, Phase 3 trial which showed improved three-year overall survival rates for the immunotherapy combination, in comparison to chemotherapy. The NICE decision follows approval for combination therapy by the Scottish Medicines Consortium earlier this year.

Exposure to asbestos in the workplace is responsible for over 80 per cent of mesothelioma cases. The Work and Pensions Select Committee has described continuing asbestos related illness as one of the ‘great workplace tragedies of modern times’. With the risk to health only likely to increase as buildings are adapted in the move to net zero, The Committee has called on the Government to commit to a 40-year programme for the removal of asbestos from all commercial and public buildings including hospitals, schools and council buildings.

Liz Darlison MBE, Chief Executive Officer at Mesothelioma UK said: “Mesothelioma is a devastating and hard to treat disease with people often diagnosed at a late stage and typically facing a poor prognosis. This decision from NICE has the potential to change the outlook for patients with MPM.

“We know that asbestos exposure causes the majority of MPM cases, and it is important that we continue to raise awareness of the symptoms and risk factors. This is a significant advance in treatment which gives patients the potential to live a better quality of life with this cancer”

Nick Maskell, Professor of Respiratory Medicine at the University of Bristol and Chair of Mesothelioma UK added: “We are extremely pleased with this long-awaited decision from NICE. It is brilliant news for mesothelioma patients and their families. We look forward to integrating first line ipilimumab/nivolumab into our treatment pathways.

“Combination immunotherapy with ipilimumab/nivolumab has shown superiority over chemotherapy and the decision to approve this provides a new routinely available standard of care for NHS patients. This progress would not be possible without the Checkmate 743 trial and underlines the importance of clinical trials and the value of patient participation.  We are very grateful to patients that enter clinical trials, which often requires them to take on the extra burden of trial visits, tests and travel, to help advance research and treatment for us all.

“Finally, I am very proud of Mesothelioma UK who have advocated unceasingly for this new treatment. We are here for anyone affected by Mesothelioma and will continue to do all that we can.”

July 14, 2022

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