Hundreds of women with hard-to-treat ovarian cancer can now be offered a new life-prolonging treatment, after NHS England approved its introduction. It is the first new drug for resistant ovarian cancer to be approved for more than 20 years.
Ovarian is the 18th most common type of cancer globally, affecting more than 300,000 women a year. More than three-quarters of patients are diagnosed at an advanced stage, making it harder to treat.
Standard treatment for ovarian cancer typically involves surgery and chemotherapy, but about 80% of patients with advanced disease relapse and most eventually develop resistance to chemotherapy.
According to the National Institute for Health and Care Excellence (Nice), patients with folate receptor-alpha-positive platinum-resistant epithelial (FRα) cancers have until now had limited options when their tumours stop responding to standard chemotherapy.
Now Nice has approved the drug mirvetuximab soravtansine for patients with epithelial ovarian, peritoneal or fallopian tube cancer that has become resistant to platinum-based chemotherapy and whose tumours contain the FRα protein that the drug targets.
NHS England said up to 400 women a year in England could benefit, in what it described as a major milestone for treatment.
Prof Ruth Plummer, NHS England’s national clinical lead for cancer drugs, said: “This represents the most significant breakthrough in NHS treatment for these hard-to-treat ovarian cancers in over two decades – and we’re delighted it will now offer hundreds of women much-needed hope of precious extra time with their loved ones.”
Mirvetuximab soravtansine, known as Elahere, is administered by a drip once every three weeks. A global clinical trial involving eight NHS hospitals found that the treatment delayed cancer progression and prolonged survival by an average of four months, compared with just receiving chemotherapy, with more manageable side-effects. In more than a third of patients (37%), tumours shrank by at least 30%, compared with 16% with chemotherapy.
The drug, made by AbbVie, combines a “homing” antibody, which seeks out the FRα protein on the surface of cancer cells, with a cancer-killing molecule that destroys the cell from within.
Experts said the decision was a seminal moment and could significantly improve the quality of life of affected patients. Rachel Downing, the head of policy and external affairs at Target Ovarian Cancer, said: “This is a hugely important moment for women with platinum-resistant ovarian cancer and their families, who have faced limited effective treatment options for far too long. Today’s announcement offers real hope of improved quality of life.”
Victoria Clare, the chief executive of the charity Ovacome, said: “Today marks a landmark moment. Being told that platinum-based chemotherapy is no longer working can bring anxiety and uncertainty, particularly when the disease is at an advanced stage, where time and options are limited. This recommendation is the first in over 20 years to offer the ovarian cancer community an additional choice at a critical stage, with the potential to make a real difference to patients and their families.”
Helen Knight, the director of medicines evaluation at Nice, said: “We heard clearly from patients and clinicians about the very limited options available at this stage of the disease and the substantial burden that chemotherapy places on women’s lives. We are pleased that, following a robust process and a new commercial arrangement with AbbVie, we are now able to recommend this treatment for NHS use.”
