Cancer patients set to receive wonder drug tucatinib, which melts tumours, ahead of wider NHS rollout

A breast cancer drug that can melt away tumors in weeks has been given the green light for NHS patients in Scotland – raising hopes that health chiefs across the rest of the UK will soon follow suit.

Experts and patient groups were deeply disappointed last October when the National Institute for Health and Care Excellence (NICE), England’s prescription watchdog, did not recommend the drug, tucatinib, even though it has shown great promise for women with advanced HER2 positive. breast cancer – a difficult to treat form of the disease.

The body raised technical concerns about how the drug was studied.

But last week the Scottish Medicines Consortium announced it would fund twice-daily tablets for women who had failed to respond to other medications and had seen their cancer come back.

The decision came just days after new trial results emerged showing that tucatinib, in combination with chemotherapy and another drug, trastuzumab, also known as Herceptin, held the disease at bay. longer distance and increased survival time.

Importantly, the drug, also known by the brand name Tukysa, has been shown to be very effective in targeting tumors that appear in the brain – and experts are currently studying whether giving the tablets to women with HER2-positive breast cancer at an early stage could prevent the disease from spreading there, as it does in half of the cases.

Dr David Cameron, professor of oncology at the University of Edinburgh who was involved in the clinical trial of the drug, said: “This is potentially a breakthrough treatment for the many patients who desperately need it. .”

One woman who received tucatinib said she agreed to take the drug as part of a trial “because I had nothing to lose” after other treatments failed.

When mother-of-four Lesley Stephen was diagnosed with HER2-positive breast cancer in 2014 at the age of 48, it had already spread to her bones, liver and lungs.

A year later, tumors appeared in his brain. Chemotherapy and radiation cleared them, but the cancer returned to his lungs.

Mother-of-four Lesley Stephen benefited from tucatinib and said she agreed to take the drug as part of a trial ‘because I had nothing to lose’ after other treatments failed .

After a family vacation to New York that Lesley thought was her last because she said doctors told her to ‘get my things in order’, her oncologist offered her the last available spot on a clinical trial. in Glasgow on tucatinib.

“I chose the trial option because I had nothing to lose and I had an immediate and very strong response,” she said.

cancer fact

One in seven women in the UK will develop breast cancer in their lifetime, according to the charity Breast Cancer Now.

“At first, scans of my lungs showed white spots – tumors – all over. It looked like a Jackson Pollock painting.

“After three weeks, they were gone. There were a few scars left, but it was as if the tumors had melted away.

Communications consultant Lesley, who lives in Edinburgh with her husband Doug, 50, a human resources director, added: ‘I’m still on this drug now, over six years later, and my brain tumors are never income.

“I’ve been able to live a pretty normal life with my family for over six years and I’ve been able to experience some of those milestones that I thought cancer took away from me – seeing my two eldest go to college and my younger go to high school. It has been a miraculous lifesaver for me.

About 55,000 Britons are diagnosed with breast cancer each year, mostly women over 50.

The treatments mean the outlook for the most part is positive, with more than three-quarters of women surviving at least ten years after diagnosis.

But one in five patients have a type of breast cancer that produces excessive amounts of a protein involved in cell growth, HER2.

These tumors, called HER2 positive, are three times more likely to spread to other parts of the body, compared to other forms of breast cancer.

Half of women with HER2-positive breast cancer go on to develop brain tumours.

To add to this, even if the cancer is initially eradicated, the tumors can come back – either in the breast or elsewhere, where they are known as metastases.

About 55,000 Britons are diagnosed with breast cancer each year, mostly women over 50. [File image]

There are medications and other treatments for these patients, but the effects are short-lived and many run out of options within months.

A major breakthrough in the treatment of HER2-positive patients came in May last year, with the approval of trastuzumab deruxtecan, or Enhertu, a drug that shortened the time cancer was kept at bay from seven months to more than two years – results that have been called “mind-blowing” by experts.

Tucatinib is another step forward, said Peter Schmid, professor of cancer medicine at Barts Cancer Center.

“Trastuzumab deruxtecan was a major breakthrough for patients with incurable HER2-positive breast cancer, but eventually it stopped working,” he said.

“Tucatinib gives us an additional treatment to help us control the disease a little longer and keep patients healthy so they can live their lives.”

He added: “The great hope now is that giving tucatinib to patients with early-stage HER2-positive breast cancer can prevent the formation of brain metastases, and trials are underway to find out. “

Tucatinib is one of a class of drugs known as tyrosine kinase inhibitors, or TKIs, which work by blocking chemicals that help cancer cells grow and divide.

Lesley said that early in her treatment she saw

Lesley said early in her treatment she saw colorful “splatters” all over her lungs “like a Jackson Pollock painting” until she started using tucatinib.

The Scottish approval follows a study known as HER2CLIMB, which found that tucatinib, taken in combination with the chemotherapy drug trastuzumab and capecitabine, reduced the risk of death by just over a half. third and 46% disease progression, compared to taking trastuzumab and capecitabine. alone.

This improvement was seen whether the patients had brain tumors or not.

Lesley, who is the mother of Finn, 21, Alex, 20, Archie, 17 and Evie, 13, describes the effect of the drug as “absolutely amazing”, adding: “Before taking it, I was so breathless from the tumors in my lungs, I could barely climb the stairs.

“Now I live a pretty normal life. It’s vital that every woman in the UK who needs it can get it.

NICE is due to make a final decision on tucatinib in March, and it is now hoped that it will overturn previous guidance.

Baroness Delyth Morgan, chief executive of Breast Cancer Now, said the Scottish ruling was “a significant leap forward for women with incurable HER2-positive secondary breast cancer” which brought “hope to patients who urgently need new effective options”.

She added: “The pharmaceutical company that makes it, Seagen and NICE must continue to work together as a matter of urgency to ensure that it can also be recommended for routine use on the NHS in England, so that more patients can benefit from it.”

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