Συντακτική ομάδα ΦΚ

Σε επαναξιολόγηση αντικαρκινικών φαρμάκων προχωρά το NHS

17/11/2014 11:08:02 πμ

Τη σχέση κλινικού οφέλους και κόστους του φαρμάκου μελετά η Βρετανία και σε υπάρχοντα και σε νέα σκευάσματα

Σε επαναξιολόγηση υφιστάμενων αντικαρκινικών φαρμάκων, καθώς και σε αξιολόγηση νέων θα προχωρήσει ο εθνικός φορέας υγείας NHS England, του Ηνωμένου Βασιλείου, προκειμένου να εκτιμήσει το κλινικό όφελος στη θεραπεία του ασθενούς, σε σχέση με το κόστος κάθε φαρμάκου.

Όπως μεταδίδει το FiercePharma, στον κατάλογο περιλαμβάνονται αρκετά top-selling σκευάσματα μεγάλων φαρμακευτικών εταιρειών, τα οποία και πιθανώς να δεχθούν «πλήγμα» σε περίπτωση αρνητικής ή ουδέτερης αξιολόγησης. Ομάδες ασθενών και φαρμακευτικές επιχειρήσεις δεν είναι «ευχαριστημένοι» για τα σχέδια επαναξιολόγησης, καθώς το National Institute for Health and Care Excellence πιέζει για περικοπές στις δαπάνες του εθνικού συστήματος Υγείας.

Σύμφωνα με το NHS England, η παρακάτω λίστα των φαρμάκων, θα πρέπει να αξιολογηθούν εκ νέου στην επόμενη σύνοδο, που θα πραγματοποιηθεί στις 15 και 16 Δεκεμβρίου 2014.

Τα φάρμακα υπό αξιολόγηση είναι:

Τύπος καρκίνου	Φάρμακο και ένδειξη
Breast	Eribulin (Halaven) – metastatic breast cancer previously treated with two prior chemotherapy regimens for advanced disease
Breast	Lapatinib (Tyverb) – Second or further line HER2+ metastatic breast cancer
Breast	Pertuzumab (Perjeta) – First line HER2+ metastatic breast cancer
Breast	Trastuzumab Emtansine (Kadcyla) – Second or further line treatment of HER2+ metastatic breast cancer
Breast	Bevacizumab (Avastin) – First or second line treatment for triple negative metastatic breast cancer in combination with paclitaxel
Breast	Everolimus (Afinitor) – HR+, HER2- metastatic breast cancer
CLL	Ofatumumab (Arzerra) – Second and subsequent line treatment of chronic lymphocytic leukaemia
CLL	Idelalisib (Zydelig) – relapsed chronic lymphocytic leukaemia in combination with rituximab not eligible for cytotoxic therapies
Colorectal	Cetuximab (Erbitux) – Second or third line RAS wt metastatic colorectal cancer with combination chemotherapy
Colorectal	Bevacizumab (Avastin) – First line metastatic colorectal cancer with oxaliplatin-based or irinotecan-based chemotherapy
Colorectal	Bevacizumab (Avastin) – First line metastatic colorectal cancer with SA fluoropyrimidine
Colorectal	Aflibercept (Zaltrap) – Second line metastatic colorectal cancer in combination with irinotecan-based combination chemotherapy
Colorectal	Cetuximab (Erbitux) – First line RAS wt metastatic colorectal cancer with oxaliplatin-based chemotherapy
Colorectal	Cetuximab (Eerbitux) – First line RAS wt metastatic colorectal cancer with irinotecan-based chemotherapy
Leukaemia	Bosutinib (Bosulif) – Treatment of blast phase chronic myeloid leukaemia refractory or intolerant to nilotinib or dasatinib
Leukaemia	Dasatinib (Sprycel) – Lymphoid blast phase chronic myeloid leukaemia with resistance or intolerance to prior therapy
Leukaemia	Dasatinib (Sprycel) – Ph+ acute lymphoblastic leukaemia with resistance or intolerance to prior therapy
Leukaemia	Bosutinib (Bosulif) – treatment of chronic phase chronic myeloid leukaemia refractory or intolerant to nilotinib or dasatinib
Leukaemia	Bosutinib (Bosulif) – treatment of accelerated phase chronic myeloid leukaemia refractory or intolerant to nilotinib or dasatanib
Lung	Pemetrexed ((Alimta) – Second line metastatic non-squamous non-small cell lung cancer (in patients who could not access pemetrexed as part of first line or maintenance therapy)
Lung	Pemetrexed (Alimta) – maintenance treatment of metastatic non-squamous non-small cell lung cancer previously treated with induction pemetrexed-based chemotherapy
Lung	Crizotinib (Xalkori) – Second line ALK + metastatic non-small cell lung cancer
Lymphoma	Bendamustine (Levact) – Rituximab refractory low grade non-Hodgkins lymphoma
Lymphoma	Bortezomib (Velcade) – relapsed/refractory mantle cell lymphoma
Lymphoma	Bortezomib (Velcade) – relapsed Waldenstrom’s macroglobulinaemia
Lymphoma	Brentuximab (Adcetris) – bridge to allograft transplant for the treatment of Hodgkin’s Lymphoma
Lymphoma	Brentuximab (Adcetris) – relapsed or refractory Hodgkins lymphoma after at least two prior chemotherapy regimens when high dose or multi-agent chemotherapy is not an option
Lymphoma	Brentuximab (Adcetris) – bridge to allograft transplant for the treatment of anaplastic large cell lymphoma
Myeloma	Bortezomib (Velcade) – relapsed/refractory multiple myeloma with prior response to Bortezomib
Myeloma	Bortezomib (Velcade) – Bortezomib naïve relapsed multiple myeloma
Myeloma	Lenalidomide (Revlimid) – Second line multiple myeloma (CI to Bortezomib)
Myeloma	Pomalidomide (Imnovid) – relapsed/refractory multiple myeloma after 2 or more prior therapies
Neuroendocrine	Everolimus (Afinitor) – First or second line pancreatic neuroendocrine tumours
Ovarian	Bevacizumab (Avastin) – Second line platinum sensitive advanced ovarian cancer
Paediatrics	Bevacizumab (Avastin) – Third or further line treatment of low grade gliomas of childhood
Pancreas	Albumin bound paclitaxel (Abraxane) – First line stage IV advanced pancreatic cancer with gemcitabine
Prostate	Cabazitaxel (Jevtana) – Second or Third line advanced castrate resistance prostate cancer
Renal	Axitinib (Inlyta) – Second line advanced renal cell carcinoma
Renal	Everolimus Afinitor) – Second line advanced renal carcinoma
Sarcoma	Pazopanib (Votrient) – Third or further line treatment of metastatic non-adipocytic soft tissue sarcoma
Sarcoma	Regorafenib (Stivarga) – advanced gastrointestinal stromal tumour after failure of at least previous imatinib and sunitinib
Sarcoma	Pegylated liposomal doxorubicin (Caelyx) – First line treatment of primary sarcoma of the heart and great vessels or angiosarcomas or sarcoma patients with cardiac impairment requiring anthracycline therapy

Επίσης νέα φάρμακα που τίθενται σε αξιολόγηση για την ένταξή τους στο Εθνικό Σύστημα Υγείας της Βρετανίας είναι:

New drugs for evaluation

Type of cancer	Drug and indication
Breast	Eribulin – Second line treatment of metastatic breast cancer
CLL	Idelalisib – First line chronic lymphocytic leukaemia in high risk patients i.e. 17p deletion and/or a mutation of the TP53 gene
CLL	Ibrutinib – relapsed or first line chronic lymphocytic leukaemia in 17p deletion or TP53 mutation
Colorectal	Panitumumab – second line RAS wt metastatic colorectal cancer with chemotherapy
Colorectal	Panitumumab – Third line RAS wt metastatic colorectal cancer with chemotherapy
HCL	Vemurafenib – last line relapsed/refractory hairy cell leukaemia carrying the BRAF-V600 mutation
Lung	Nindetanib – Second line metastatic non-small cell lung cancer (adenocarcinoma) in combination with docetaxel
Lymphoma	Ibrutinib – relapsed or refractory mantle cell lymphoma
Ovarian	Bevacizumab – Second line platinum resistant advanced ovarian cancer
Ovarian	Trabectedin – relapsed partially platinum sensitive (PPS) advanced ovarian cancer
Ovarian	Olaparib – maintenance treatment of platinum sensitive relapsed BRCA mutated advanced ovarian cancer
Thyroid	Cabozantinib – Second line treatment metastatic medullary thyroid cancer in prior TKI treated patients