The future of cancer treatment has never been more exciting.
A third of new medicines being developed are cancer treatments, and a significant number of these are to treat rare cancers. i
There are also a growing number of innovative cell and gene therapies for cancer being developed – these aim to treat diseases by replacing and inactivating a tumour’s cells and genetic codes.
Despite efforts to improve the situation, five-year survival rates in the UK for many cancers, including breast, cervix, colon, rectum, lung and stomach cancerii, continue to lag behind other countries.
The UK’s poor performance stems from a variety of factors,iii but we believe that better use of new medicines can be an important part of the solution.
To ensure patients get these treatments, there are four crucial steps to take:
1. Strengthen clinical research
Clinical trials are essential for developing new cancer treatments, but over recent years, the UK has become a less attractive place for companies to run them.iv
This risks patients in the UK missing out on early access to innovative cancer medicines, with participation in industry clinical trials in England recently falling by 35%.v
There must be a focus on rapidly improving timelines to approve and set-up clinical trials, including those for cancer, and addressing workforce and capacity constraints which are hindering patient recruitment.
2. Improve access to, and use of, diagnostics to identify cases earlier
In 2020, almost half of cancer cases in England were diagnosed at stage 3 or 4, a total of more than 104,000 cases.vi This must change, and we already have the technology to do it.
Genomic testing is revolutionising cancer diagnostics and treatment, helping to identify the right patient for precision medicines.
However, testing via the NHS Genomic Medicine Service is too often delayed, so results cannot be considered when planning patient treatment.
The South-East Genomics regional hub reported an average turnaround time of 12 months when the target is 84 days.vii
We want to see standardised processes for genomic testing across all four UK nations, that ensure testing is delivered in clinically relevant timelines, helping patients get the diagnosis and best treatments they need.viii
3. Continue to evolve the system assessing whether new cancer medicines are clinically and cost effective for the NHS
NICE, Scottish Medicines Consortium and the All-Wales Medicines Strategy Group make robust decisions on which new medicines represent value for money and should be available through the NHS.
However, the methods used for these assessments can present significant challenges for some cancer medicines.
In recent years, increasing numbers of NICE evaluations for cancer medicines have been terminated without the medicine getting a positive recommendation – meaning NHS patients will not get access to them. ix
NICE concluded an extensive review of its methods in January 2022, making several changes. In fully implementing these, it is important for NICE to use the flexibilities that have been introduced to support decision-making about a medicine’s value for money for the NHS.
For example, with rare cancers, there is inevitably less data available, because the disease affects a small number of patients and this should not present a barrier to patient access.
There are a number of ways to build the evidence base – the Cancer Drugs Fund is one example in action. It has allowed tens of thousands of NHS patients earlier access to cancer drugs deemed by NICE to potentially be value for money, but which need more evidence before entering routine commissioning.
4. Tackle long-standing variations in the use of innovative medicines
Cancer patients can be disadvantaged by variations in the use of NICE-approved innovative medicines.
For example, in the period from 2019 to March 2022, the least well-off in society were half as likely to get the cell therapy treatment known as CAR-T compared to the most well-off.x
We need to see more equitable use of cancer medicines across the country, driven by consistent implementation of NICE guidance and clinical guidelines, with effective monitoring of medicines’ uptake by the NHS at a regional level.
Cancer patients in the UK deserve to get the best possible treatments, at the time when they need them.
Taking these four steps will help the Government make sure they get them.