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Skin and breast cancer drugs approved for NHS use in Scotland

Two cancer drugs have been approved for patients on the NHS in Scotland. An immunotherapy for some p..

Two cancer drugs have been approved for patients on the NHS in Scotland. An immunotherapy for some people with advanced skin cancer and a targeted drug for some patients with breast cancer got the green light this week.

The fresh batch of decisions from the Scottish Medicines Consortium (SMC) this week were hailed as “great news” by Gordon Matheson, Cancer Research UKs public affairs manager in Scotland.

“The decisions mean that a treatment called pembrolizumab is now available for some patients whose skin cancer has spread to the lymph nodes.”

Pembrolizumab (Keytruda) will now be an option for patients whose melanoma has spread to the lymph nodes and who have already had surgery.

Matheson said the treatment provides another treatment option for patients whove had surgery to remove their cancer but who are at high risk of it returning.

New option for patients with melanoma after surgery

Pembrolizumab works by boosting the immune systems ability to kill cancer cells and can help target any cancer cells left behind after surgery.

In a clinical trial involving over 1000 patients, pembrolizumab increased the length of time patients lived without their cancer coming back.

15 in 20 of those taking pembrolizumab were cancer free 12 months after treatment, compared to just over 12 in 20 of those taking a dummy drug. And in data provided to the SMC, 7 in 10 patients taking pembrolizumab were alive without their cancer coming back 18 months after treatment, compared to 5 in 10 patients taking the dummy drug.

But severe side effects, including type 1 diabetes and bowel inflammation, were more common in patients taking pembrolizumab. And one person died as a result of taking pembrolizumab, which caused muscle inflammation.

Clinical experts told the SMC they considered pembrolizumab to be an advancement in treatment as it significantly reduced the risk of cancer coming back after surgery.

Pembrolizumab was approved for NHS use in England in November 2018 by the National Institute of Health and Care Excellence (NICE). NICE decisions are also adopted by Wales and Northern Ireland, so the drug should be available for eligible patients there too.

Targeted drug gets green light for advanced breast cancer

The SMC also approved two combinations, including the drug abemaciclib for breast cancer, in their latest batch of decisions.

The targeted cancer drug works by blocking growth molecules inside cancer cells, which stops them from dividing. Its been developed for patients whose cancer cells test positive for certain hormone receptors, but not the HER2 receptor.

Abemaciclib will now be available as part of two different treatment combinations to patients whose breast cancer has spread. It can either be used with the hormone treatment fulvestrant or in combination with a group of hormone therapies called aromatase inhibitors.

Both combos will be available to patients whove already had hormone therapy. But the combination of abemaciclib and aromatase inhibitors will also be available to women who havent had any treatment for their breast cancer.

Matheson said the double abemaciclib decision would “provide new treatment options for patients with HER2-negative breast cancer.”

“This will be very welcome for patients and their families,” he said.

The data behind the decisions

Combining abemaciclib with fulvestrant was shown to slow disease progression and delay the need for chemotherapy in a trial involving 669 patients with advanced breast cancer.

Taking a combination of abemaciclib and fulvestrant increased the time before patients cancers got worse, compared to taking fulvestrant alone. Patients taking the drug combo were alive for an average of 16.5 months without their cancer getting worse, compared to 9.3 months for those just taking fulvestrant.

But serious side effects were more common in the group taking the drug combination, with 1 in 5 people experiencing side effects including severe diarrhoea and blood clots.

The trial has not been running for long enough to know how much the drug combination will improve long-term survival for these patients.

Abemaciclib has also been tested in combination with an aromatase inhibitor in a separate trial involving 493 women with advanced, untreated breast cancer. Adding abemaciclib to aromatase inhibitors significantly increased the time patients lived without their disease getting worse compared to those taking aromatase inhibitors alone.

The most frequent severe side effects for those taking the combo in the trial were low levels of one type of white blood cell (neutropenia) and diarrhoea.

The two drug combinations got the green light for NHS England for a similar group of patients in January and April this year. The combos should also be available in Wales and Northern Ireland.

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I lost my arms and legs – stop it happening to others

A man who woke from a coma to discover both his arms and legs had been amputated and part of his fac..

A man who woke from a coma to discover both his arms and legs had been amputated and part of his face removed has called for mandatory training on sepsis for NHS staff.

Sepsis, or blood poisoning, is a serious complication of an infection, which can have devastating consequences if not treated quickly.

There were delays in spotting Tom Ray's sepsis.

He says a commitment is needed to avoid more tragedies.

Tom's story

Tom Ray was fit and healthy and living in Rutland in the East Midlands before he contracted sepsis at the age of 38 in 1999.

He had had a successful career in corporate banking and was in the process of setting up a business with his pregnant wife, Nic, when he fell ill.

His sepsis – thought to be caused by a cut to his gum during a trip to the dentist, combined with a chest infection – came on rapidly and led to vomiting and a high temperature.

But it took five hours at the hospital he was admitted to before the condition was diagnosed.

He spent months in a coma, during which time his wife Nic gave birth to their second child, Freddy.

His recovery has been a long and gruelling process, involving years of plastic surgery. (more…)

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Health

I lost my arms and legs – stop it happening to others

A man who woke from a coma to discover both his arms and legs had been amputated and part of his fac..

A man who woke from a coma to discover both his arms and legs had been amputated and part of his face removed has called for mandatory training on sepsis for NHS staff.

Sepsis, or blood poisoning, is a serious complication of an infection, which can have devastating consequences if not treated quickly.

There were delays in spotting Tom Ray's sepsis.

He says a commitment is needed to avoid more tragedies.

Tom's story

Tom Ray was fit and healthy and living in Rutland in the East Midlands before he contracted sepsis at the age of 38 in 1999.

He had had a successful career in corporate banking and was in the process of setting up a business with his pregnant wife, Nic, when he fell ill.

His sepsis – thought to be caused by a cut to his gum during a trip to the dentist, combined with a chest infection – came on rapidly and led to vomiting and a high temperature.

But it took five hours at the hospital he was admitted to before the condition was diagnosed.

He spent months in a coma, during which time his wife Nic gave birth to their second child, Freddy.

His recovery has been a long and gruelling process, involving years of plastic surgery. (more…)

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NHS ‘should not prescribe acne drug’

The parents of young people who have killed themselves and patients unable to have sex are calling f..

The parents of young people who have killed themselves and patients unable to have sex are calling for the NHS to stop prescribing acne drug Roaccutane.

Ed Henthorn said it had caused him erectile dysfunction, psychosis and suicidal thoughts.

And one man who believes his son killed himself after taking the drug said the risks "are just too high".

Manufacturer Roche said "millions of patients worldwide have benefited from taking the drug".

The majority of those who take the drug have a positive experience.

'Pretty overwhelming'

"I used to think about girls… but my feelings, thoughts, just faded away," Ed Henthorn told the BBC's Victoria Derbyshire programme.

He was 19 when he took Roaccutane. He describes his acne as mild but bad enough to want to treat.

After three weeks he started to experience side-effects, including reduced energy and sex drive.

Then he experienced erectile dysfunction.

"That was why I decided to stop taking it," he said. (more…)

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