National Institute of Health and Care Excellence (NICE) has approved Merck & Co., Inc. (MSD’s) Keytruda. Keytruda is the first immunotherapy to be used for metastatic squamous NSCLC regardless of PD-L1 expression. It can be used in the three-way combination. It includes two chemotherapy drugs, carboplatin, and nabpaclitaxel or paclitaxel. It an option for untreated metastatic squamous non-small-cell lung cancer (NSCLC) in adults. According to NICE, the recommendation was confirmed by data released by Phase III KEYNOTE-407 trial. It is found that drugs improved overall survival (OS) in adults. It improved survival by 15.9 months as compared to 11.3 months. It also reduced the risk of death by 36% as compared to chemotherapy. As per Louise Houson, UK managing director of MSD, the majority of lung cancer patients have access to some form of immunotherapy. It includes patients with particularly hard to treat forms of such disease.
As per NICE’s estimation, the cost of the drug is more than the regulator’s maximum guideline of £50,000 per quality. Merck’s KEYNOTE-407 clinical advancement program recommends that the Keytruda combination treatment enables people to live longer and without cancer advancing than chemotherapy alone. For instance, In June 2018, the company introduced Keytruda plus chemotherapy. It reduced the risk of death by half as compared to chemotherapy alone. However, pembrolizumab combination therapy is only available through the Cancer Drugs Fund, because of the ongoing KEYNOTE-407 trial. This data is immature and the cost-effectiveness of the drug is uncertain.
NICE also advise that it is only recommended if the treatment with Tecentriq and Avastin is stopped at two years. Because cost-effectiveness was limited to 2-years of treatment. The company is expected to provide the drug according to the managed access agreement. As per data published by IMpower 150 trial, people having Tecentriq and Avastin, plus carboplatin and paclitaxel is expected to live longer than those having the standard treatment.