ABRAXANE (paclitaxel formulated as albumin bound nanoparticles; nab-paclitaxel), in combination with gemcitabine, has been recommended for use within NHS Scotland by the Scottish Medicines Consortium (SMC) for the treatment of metastatic adenocarcinoma of the pancreas.1 The decision follows the recent NHS England announcement to defer their review of ABRAXANE for metastatic pancreatic cancer, allowing the treatment to remain on the Cancer Drugs Fund (CDF) until a final decision is made.2,3
Currently, pancreatic cancer is the 5th most common cancer killer in the UK with approximately 8,800 new cases diagnosed each year.4,5 For people whose cancer has already spread to another part of their body, the average life expectancy can be only a few months, depending on the extent of the cancer growth and where it has spread.6 In Scotland an estimated 770 new patients are diagnosed and approximately 740 die from the disease each year, representing 4.7% of cancer deaths in Scotland each year. 7
Professor Jeff Evans, Professor of the Translational Cancer Research, University of Glasgow, said: "I welcome the Scottish Medicine Consortium decision to approve the prescribing of ABRAXANE in Scotland. Pancreatic cancer has extremely low survival rates as the majority of patients are diagnosed at an advanced stage. ABRAXANE has shown that it is able to increase survival for patients with metastatic pancreatic cancer and now sufferers of the disease in Scotland will be able to use this treatment."
The SMC decision is based on results from the MPACT (Metastatic Pancreatic Adenocarcinoma Clinical Trial) study, published in the October 2013 edition of the New England Journal of Medicine, which demonstrated an increase in median overall survival of 1.8 months when compared to gemcitabine alone [(8.5 months vs. 6.7 months respectively) (HR 0.72; 95% CI 0.62 to 0.83 P<0.001)].8 Updated results from post-hoc analysis of the MPACT trial based on an extended data cut-off (8 months) at the time the trial was closed demonstrated an increase in the median overall survival benefit of 2.1 months when compared to gemcitabine alone [(8.7 months vs. 6.6 months respectively) (HR 0.72,95% CI = 0.62 to 0.83, P<.001)].9
Ms Alex Ford, Chief Executive of Pancreatic Cancer UK, said: "We are absolutely delighted with the SMC's decision. They have listened to the positive input received from patients and clinicians and they should be applauded for doing so.
The decision means that eligible patients in Scotland will be now be able to access this treatment for free on the NHS, alongside patients in England and Wales, which is fantastic news. It is particularly important as, currently, pancreatic cancer causes almost 5% of cancer deaths in Scotland and it is important that as many patients as possible are given every opportunity to access life-extending treatment. And whilst not every patient will be fit enough to be able to use ABRAXANE, a significant number will and we hope this will give them the opportunity of spending more time with their loved ones."
Ali Stunt, Founder and CEO of Pancreatic Cancer Action said: "This is fantastic news for metastatic pancreatic cancer patients in Scotland who have been waiting for this treatment for almost 12 months. The unmet need in pancreatic cancer is significant due to the terrible prognosis associated with the disease and the lack of new treatments that are coming through. At Pancreatic Cancer Action, we welcome the SMC's decision to make ABRAXANE available to all eligible patients in Scotland."
Wim Souverijns, Vice President and General Manager, Celgene UK & Ireland, said: "Celgene is dedicated to working with all the reimbursement bodies in the UK and Ireland to make sure that as many eligible metastatic pancreatic cancer patients can be treated with ABRAXANE, in combination with gemcitabine, as possible. Access to innovative cancer medicines generates clear benefits to patients.
Therefore, widening access to life-extending treatments for cancer patients has the potential to reduce the rise in cancer mortality rates that has been seen over the last two decades and help to increase survival rates in pancreatic cancer which have hardly moved in decades.
The SMC have recognised the clinical benefit of ABRAXANE, in combination with gemcitabine, so Scottish patients will now be able to receive the treatment alongside their counterparts in England and Wales."