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Win for cancer patients may be end to chemotherapy as immunotherapies fast-tracked

Sue DunlevyNews Corp Australia Network

EXCLUSIVE

CHEMOTHERAPY could become a thing of the past for up to two in three cancer patients with the government looking at subsidising breakthrough new immunotherapies across multiple cancers.

The medicines called programmed-death ligand 1 (PDL1) therapies — like Keytruda which dramatically extended the life of Liberal Party fundraiser Ron Walker, and Opdivo — use the body’s own immune system to fight cancer.

Currently the $150,000 per patient per year treatments are only subsidised for five types of cancer in the case of Keytruda and eight for Opdivo.

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And when pharmaceutical companies want the drugs subsidised for other cancers they have to apply separately and each application can take up to 18 months to approve.

Immunotherapies could soon be subsidised to treat more cancer types.
Camera IconImmunotherapies could soon be subsidised to treat more cancer types. Credit: Supplied

An application to provide a subsidy for Keytruda for lung cancer has already been rejected twice and is up for a third hearing next month.

Pharmaceutical company MSD is looking at seeking subsidy for Keytruda in a further 20 cancer types over the next two years and cancer patients who could benefit are in limbo until multiple applications are considered.

To fast-track this process Health Minister Greg Hunt has asked the Pharmaceutical Benefits Advisory Committee to hold a special meeting in August where it will look at approving subsidies for these medications for multiple cancer indications.

If it results in subsidies being approved for multiple cancer types it will be a major win for cancer patients.

It could see 30 per cent of patients using the new therapies go into remission and another 30 per cent suffer fewer side effects from cancer treatment.

The therapies do not work in around a third of cancer patients but there are medical tests that can indicate which patients are likely to respond well.

Chemotherapy could become a thing of the past for more cancer patients.
Camera IconChemotherapy could become a thing of the past for more cancer patients. Credit: Supplied, supplied.

In a letter to pharmaceutical companies the PBAC says a pan tumour indication listing could reduce the number of applications to the PBAC and improve access to treatments.

However, it says there are currently only limited clinical trial results available on these therapies and results are not uniform across different cancers, age groups or populations.

It is still too early to be able to compare the outcomes from these treatments with existing treatments, it says.

And it warns there are questions about tests which indicate whether cancer patients will respond to the therapies.

University of Adelaide economics experts Professor Jonathan Pincus suffers from the rare Merkel Cell Carcinoma and has had to spend almost $90,000 funding his treatment with Keytruda because there is no subsidy for his condition.

The 78 year old has continued to work as a consultant for Telstra, the Pharmacy Guild and other companies to find the money to pay for his treatment.

If he had melanoma, one of the five diseases where there is a government subsidy, he would be able to purchase the treatment for just $39.40.

Before he started the treatment Professor Pincus had three tumours grow in rapid succession requiring surgery to remove them but since he started Keytruda he has developed no new visible lesions.

He has continued to work, goes bicycling, does tai chi, sings and is involved in fighting for a better deal for rare cancer sufferers.

“Without this medication I was looking at death,” he said.

He says the Pharnaceutical Benefits Advisory Committe in charge of approving medical subsidies needs to reform the way it works because new cancer medicines are not designed for single diseases.

Providing approval fpr the drug to be used in multiple types of cancer may be the only way people with rare cancers like him ever get a subsidy, he said.

MSD says it is excited about working with the PBAC, government, industry and patients on a solution to give Australian cancer patients access to new innovative immune-oncology therapies much sooner than currently possible.

“We expect these types of medicines to have a very positive impact on the way cancer is treated in this country,” a spokesman said.

Bristol-Myers Squibb said last week the TGA approved OPDIVO® for the treatment of advanced bladder cancer and it is currently being investigated for the treatment of a wide range of other cancers.

“Bristol-Myers Squibb looks forward to working closely with the Government to discuss the potential for a pan-tumour framework to improve access to these cancer immunotherapies for Australian patient,” a spokeswoman said.

Director of Public Policy at Cancer Council Australia, Paul Grogan, said he was unaware of any potential changes in the evaluation of cancer drugs by class, however any reform that would get oncology medicines to those who might benefit from them sooner should be welcomed.

“Whatever reforms the government might be looking at, the ongoing challenge to a fairer outcome is likely to be the pricing policies of the multinational drug companies,” he said.

The regulators are catching up with scientific breakthroughs.
Camera IconThe regulators are catching up with scientific breakthroughs. Credit: ThinkStock, Thinkstock.

Rare Cancers spokesman Richard Vines said a cancer forum in Canberra had asked for this approach in August last year.

“This will make such a difference for rare cancer patients, it will really give them hope they will get treatments listed, it would be amazing,” he said.

The US Food and Drug Administration had already listed immunotherapies for multiple tumour applications, he said.

This was the first indication Australia’s regulatory system was attempting to keep up with rapid developments in science, he said.

“We’ve go the new technologies we need to make the most of it,” he said.

Originally published as The end for chemotherapy