Patients with skin cancer in England look set to be the first in Europe to have access to a new drug combination.
The National Institute for Health and Care Excellence has published final draft guidance backing nivolumab (Opdivo) with ipilimumab (Yervoy).
“The evidence we examined was very promising”
The drugs can stall progression of advanced – unresectable or metastatic – melanoma by an average of eight months compared with standard treatment, said NICE. Life expectancy for those with advanced skin cancer is currently under two years.
About 1,300 people could be eligible for the drug combination each year. Both drugs are manufactured by Bristol-Myers Squibb.
The institute described nivolumab and ipilimumab as part of an “exciting new class of immunotherapy cancer treatments that disable the natural restrictions preventing the immune system fighting cancer cells”.
Professor Carole Longson, director of the Health Technology Evaluation Centre at NICE, said: “After one of the fastest drug appraisals NICE has carried out, these promising new immunotherapy treatments for advanced melanoma look set to significantly extend the life of people with the condition.
“The evidence we examined was very promising and I know further trials are ongoing which have also released encouraging data,” she said.
Nivolumab has a list price of £439 per 4ml (40mg) vial (excluding VAT) and ipilimumab has a list price of £3,750 per 10ml (50mg) vial or £15,000 per 40ml (200mg) vial (excluding VAT).
Professor Carole Longson
However, the NHS will receive a discount on the treatment agreed between the company and the Department of Health, which is commercial in confidence.
Recommended dosage is related to body weight.
The final draft guidance is now with consultees. Once NICE issues final guidance, the NHS must make sure it is available within three months of its date of publication.
In February, NICE recommended nivolumab (Opdivo) on its own for advanced melanoma. NICE has also recommended ipilimumab (Yervoy) as a possible treatment option for adults with advanced melanoma twice – once in patients that have not been treated before and again in patients that have previously been treated.
In addition, NICE already recommends pembrolizumab (Keytruda), which is marketed by Merck Sharp & Dohme, for advanced melanoma used before and after prior treatment with ipilimumab.