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NICE provisionally backs combined drug therapy for skin cancer

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The National Institute for Health and Care Excellence is recommending a new drug combination for melanoma that could extend life by six months.

NICE has published final draft guidance recommending trametinib (Mekinist) in combination with dabrafenib (Tafinlar) to treat a type of skin cancer that has spread and cannot be surgically removed.

“Patients and healthcare professionals alike will welcome this positive recommendation”

Carole Longson

Patients with BRAF V600 mutation positive melanoma receiving the new treatment in two clinical trials survived an average of six months longer than those on other drugs, noted NICE.

It added that the NHS will pay a reduced price for the drugs after a discount was agreed between the company and the Department of Health.

The list price of trametinib with dabrafenib – both of which are manufactured by Novartis – per patient per 28 days is £10,080.

The final draft guidance is now with consultees, who have the opportunity to appeal against it. Once NICE recommends a treatment “as an option”, the NHS must make sure it is available within three months of its date of publication.

In February NICE backed another drug, nivolumab (Opdivo), for advanced melanoma and has also previously recommended ipilimumab (Yervoy) and pembrolizumab (Keytruda) for the condition.

Professor Carole Longson

Professor Carole Longson

Carole Longson

Professor Carole Longson, director of the NICE Health Technology Evaluation Centre, said: “This combination treatment is the latest in a line of promising new drugs for advanced melanoma we have recommended that look set to significantly extend the life of people with the condition.

“I know from testimonies presented to the [independent appraisal] committee that patients and healthcare professionals alike will welcome this positive recommendation,” she said.

Life expectancy for those with advanced melanoma is currently under two years. Melanoma accounted for around 1,750 deaths in 2012 in England.

The Scottish Medicine’s Consortium is due to publish advice on trametinib with dabrafenib for treating unresectable or metastatic melanoma with a BRAF V600 mutation in July.

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