PATIENTS in Scotland with a rare but particularly deadly form of colorectal cancer will have access to a new life-extending therapy on the NHS for the first time.
The Scottish Medicines Consortium has given the go ahead for Braftovi to be used in combination with cetuximab in patients whose cancer has the BRAF V600 genetic mutation.
This is present in around 15 per cent of patients with early-stage colorectal cancer and 6% of those whose disease has spread, with patients in this latter category typically surviving just four to six months from diagnosis.
It is more common in women and patients also tend to be younger compared to the average age of a colorectal cancer patient.
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Prognosis is described as "much worse than all other colon patients – and worse than most other solid tumour patients presenting with stage IV disease".
There had been no new treatment breakthroughs in decades until the Beacon clinical trial, an international study involving patients from 428 sites worldwide including the Beatson cancer centre in Glasgow, showed that this combined therapy extended survival by more than 50% on average in patients with metastatic cancer compared to existing chemotherapy-based treatments which have shown "minimal" effect.
Median survival was 9.3 months compared to 5.9 months in the control group.
The SMC has recommended the combined therapy for patients with metastatic BRAF-mutated colorectal cancer who have previously undergone chemotherapy.
Braftovi (also known as encorafenib) is given in tablet form with a short-infusion of cetuximab, which means patients spend less "chair time" in hospital when social distancing is limiting capacity.
The decision brings Scotland into line with the rest of the UK, where the treatment is already available. The SMC said it is expected to benefit 14 patients in the first year, rising to 25 annually by year five.
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As a non-chemotherapy treatment, it also means that patients' immune systems will be less vulnerable to coronavirus as the pandemic continues.
Dr Janet Graham, lead trialist and consultant medical oncologist at the Beatson West of Scotland Cancer Centre, said it was an "important milestone" for the colorectal cancer community.
She added that research is also underway, through the Anchor clinical trial, to determine whether the combination therapy should also be prescribed to patients with previously untreated BRAF-positive cancer.
"This is the first big advance we have seen for BRAF mutant patients," said Dr Graham.
"This trial is for patients who have already received chemotherapy first line - it will be really interesting to see if the Anchor trial which is looking at this novel combination in first line shows even bigger gains, and we are hoping those results will be available later this summer."
Clinical trials found that the combined therapy was generally well-tolerated, with the most common side effects being fatigue, nausea, diarrhoea, acne-like skin problems and loss of appetite.
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Emily Meunier, from Fife, was diagnosed with stage 4 bowel cancer in 2020.
The 40-year-old was among those put forward for the treatment due to Covid, and has seen her tumours shrink as a result.
She said: "My liver lesions have already reduced in size and I’m tolerating the drugs extremely well.
"I'm feeling much better off the chemo and with fewer visits to hospital, I am now planning ahead a little and starting to really live again.
“I’m so grateful to have this chance and reassured to know that other people in Scotland with the same condition will be able to have this new treatment option too.”
Genevieve Edwards, chief executive of Bowel Cancer UK, said: “We’re very pleased that the benefits have been recognised. This will give new hope to Scottish patients that could benefit.”
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