A breakthrough drug which uses a man-made virus to treat advanced skin cancer has been approved for use on the NHS.
The new medicine, which doubles average survival time for people with inoperable melanoma, is to be provided to patients in England for whom other drugs do not work, after NHS watchdog NICE recommended it for immediate use.
The therapy, called T-VEC, works by infecting and killing cancer cells with a genetically-modified form of the herpes virus.
The drug also harnesses the power of the body’s own immune system and directs it against tumours.
Malignant melanoma is the fifth most common cancer in the UK, with more than 14,500 diagnosed each year
Remarkably, it does this without harming healthy human cells, meaning it has far fewer side effects than chemotherapy and other cancer treatments.
Trials led by the Institute of Cancer Research in London showed that terminally-ill patients treated with the fortnightly injections lived for an average of 41 months.
Patients treated with another modern drug, an immunotherapy which until now was considered one of the best treatments for metastatic skin cancer, only lived for 21 months.
Malignant melanoma is the fifth most common cancer in the UK, with more than 14,500 diagnosed each year, and more than 2,000 people dying with the disease.
Rates of the disease have shot up by 360 per cent since the 1970s, which experts blame on the rise of cheap package holiday deals and sunbathing.
Professor Kevin Harrington of the The Institute of Cancer Research, who led the trials, said: ‘It is very exciting news that NICE has approved T-VEC for patients with advanced melanoma, making it the first of its kind to be approved for use on the NHS.
‘This is the culmination of ten years’ work on this agent.
‘T-VEC is a modified form of the herpes virus and kills cancer cells in two ways – by attacking them directly and by directing the patient’s own immune system against the tumour.
‘The treatment has not only been shown to be effective, but has relatively mild side-effects making it particularly suitable for patients who can’t be given some of the other immunotherapies on the market.’
Scientists developed T-VEC by modifying the herpes simplex virus – which causes cold sores – to attack cancer cells but be harmless to healthy cells.
It multiplies within cancer cells and bursts them from within, but scientists removed two key genes so that the virus cannot replicate in non-cancerous cells.
The new medicine, which doubles average survival time for people with inoperable melanoma, is to be provided to patients in England for whom other drugs do not work
T-VEC also releases a molecule which stimulates the immune system to attack the cancer, resulting in a twin attack from inside and outside the cancer cells.
The drug has a list price of between £3,340 and £13,360 a month, depending on the size of each patient’s tumours, but the NHS will receive an undisclosed discount on this cost.
Officials at NICE – the National Institute for Health and Care Excellence – calculated that despite the high price, the drug’s effectiveness meant it still represented better value for money than cheaper chemotherapy drugs.
Initially it has been approved for use for patients with inoperable malignant melanoma, for whom immunotherapy drugs would not work.
Roughly 100 patients a year are expected to benefit at first, but this number may rise in the future if it is judged to be suitable for use at an earlier stage.
John Kearney, general manager of drugs company Amgen UK, which sells the drug under the brand name Imlygic, said: ‘Melanoma still takes too many lives each year.
‘New medicines based on cutting-edge science, such as Imlygic, are playing their part in improving the ways that doctors and the health service as a whole can help people affected in the future.
‘Amgen has worked with the NHS to agree a patient access scheme which means the medicine can be obtained for patients at an NHS price that NICE has found to be cost-effective.
‘The scientists who invented and developed the technology leading to Imlygic really deserve to be remembered and celebrated today – as a company, they make us very proud.’
A NICE spokesman said: ‘This positive recommendation adds to the number of promising new treatments for advanced melanoma NICE has recently recommended, providing patients with more options when faced with this form of skin cancer.’
HOW TO TELL IF YOU HAVE MELANOMA?
Melanoma can appear anywhere on the body, but they most commonly appear on the back, legs, arms and face and even underneath a nail.
Though less common, they often spread to other organs in the body, making them more deadly.
The most common sign is the appearance of a new mole or spot or a change in an existing mole.
Signs to look out for include a spot that is:
- getting bigger
- changing shape
- changing colour
- bleeding or becoming crusty
- itchy or painful
A helpful way to tell the difference between a normal mole or spot and a melanoma is the ‘ABCDE’ checklist:
Asymmetrical – melanomas have two very different halves and are an irregular shape
Border – melanomas have a notched or ragged border
Colours – melanomas will be a mix of two or more colours
Diameter – melanomas are often larger than 6mm (1/4 inch) in diameter
Enlargement or elevation – a mole that changes size over time is more likely to be a melanoma
Aside from changing moles or spots on the skin, there are a number of other risk factors for melanoma.
- exposure to UV light
- having fair skin, freckles and light or red hair
- a family history of melanomas
- a personal history of melanoma or other skin cancers
- having a weakened immune system
Source: American Cancer Society