The NHS will roll out a new immunotherapy that could offer women with advanced endometrial cancer significant extra time before their disease progresses, compared with standard chemotherapy alone.
Trials have shown that adding dostarlimab (Jemperli) to chemotherapy can slow the spread of certain forms of endometrial cancer, giving patients the hope of more time to live well before their condition worsens.
The NHS will begin offering the treatment as of today (Tuesday 5 March), following approval by the National Institute for Health and Care Excellence (NICE), and it is estimated that around 150-200 women living with advanced primary or recurrent endometrial cancer will be eligible each year.
Clinical trials showed that nearly two thirds (64%) of patients treated with dostarlimab alongside standard chemotherapy had not seen their cancer progress after 12 months of treatment, more than twice the rate seen in patients treated with chemotherapy alone (24%).
The NHS has fast-tracked the promising treatment through its Cancer Drugs Fund (CDF), enabling NHS patients to have faster access while further evidence about the long-term benefits is collected, to inform whether dostarlimab could be made available for routine use in the future.
Dostarlimab is a type of immunotherapy known as a ‘checkpoint inhibitor’, which works by attaching to a specific protein (PD-L1) on the surface of the cancer cells, helping the body’s immune system to detect and attack them.
The treatment will be offered to women whose advanced or recurrent endometrial cancer has certain genetic profiles known as high microsatellite instability (MSI) or mismatch repair deficiency (dMMR), which are present in around a quarter of womb cancers.
The immunotherapy treatment is given intravenously every three weeks alongside chemotherapy for six cycles. In patients whose cancers have responded to the treatment, dostarlimab is then continued every six weeks for up to three years.
Womb cancer is the fourth most common cancer among women in the UK – with around 9,400 women diagnosed with womb cancer every year. Endometrial cancer is the most common type of womb cancer, and while it often has a better prognosis than other womb cancers if diagnosed early, advanced or recurrent endometrial carcinoma can be challenging to treat with short survival times.
Sue Woodburn, 65, from Kirkby Lonsdale, living with recurrent womb cancer, said: “It’s hard to stay positive when you’re running out of options and living with cancer is taking its toll on your mental health. Dostarlimab has made a big difference for me. It has helped me to stay positive and hopeful that I will have a decent quality of life for a good few years yet.
“Dostarlimab allows me to have a treatment without the brutal side effects. It’s a treatment that doesn’t take over my life, that enables me to plan for the future. And it gives me belief that I might see my granddaughter start school. Now I’ve finished the chemo, I feel nearly back to normal. I’ve been able to travel – and have just come back from Rome. I am back biking, playing tennis and skiing – when I actually thought I would be dead by now.
“I feel so fortunate to have received this treatment – it has given me hope for the future. Cancer patients like me need hope.”
Professor Peter Clark, NHS England’s Cancer Drugs Fund Lead, said: “The roll out of this drug as a first-line treatment on the NHS is great news for patients living with this type of womb cancer – this new immunotherapy could offer hundreds of women the hope of precious extra time to live well before their cancer progresses.
“The NHS has fast-tracked this innovative treatment through the Cancer Drugs Fund, and we’re delighted that dostarlimab today becomes the latest in a long list of cutting-edge treatments available on the NHS to help people with cancer live well with a better quality of life.”
The announcement comes less than a year after the NHS rolled out a life-extending combination therapy of pembrolizumab (Keytruda®) and lenvatinib (Lenvima®) for advanced womb cancer in women who have previously received chemotherapy.
Dr Chloe Barr, Trustee and Advocacy Lead at Peaches Womb Cancer Trust, said: “This new treatment for primary advanced or recurrent mismatch repair deficient endometrial cancer will provide options for patients currently facing the frightening reality of very few effective anti-cancer treatments.
“Today’s decision is very welcome news, and we hope that this is just the first step towards wider availability of more effective first-line treatment options for those affected by this devastating cancer.
“Peaches Womb Cancer Trust supported the NICE appraisal, and we could not have done so without the contributions of Peaches Patient Voices, a group of people affected by womb cancer whose powerful testimonies and experiences informed our submission to the appraisal process.”
Jack Harris, Vice-President UK Oncology, GSK said: “At GSK, we are proud to have worked alongside NHS England and NICE to advance cancer care in England and deliver innovation to those who need it. Today’s news is yet another example of our unwavering commitment in collaborating with organisations towards our common desire to ultimately improve the lives of people affected by cancer.”