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NICE backs new treatment option for aggressive blood cancer

A new subcutaneous treatment option has been approved for use by the NHS in England and Wales for treating of an aggressive form of blood cancer.

The National Institute for Health and Care Excellence (NICE) has recommended a new bispecific antibody for treating adults with relapsed or refractory diffuse large B-cell lymphoma (DLBCL).

“For those living with the blood cancer DLBCL it can be an emotional rollercoaster”

Lauran Cooper

It has issued final draft guidance backing epcoritamab (Tepkinly), manufactured by AbbVie, which is from a new class of therapies that help the immune system to attack and destroy cancerous cells.

Significantly, the approval of epcoritamab for DLBCL also means patients will now have access to a subcutaneous bispecific treatment option administered as an injection under the skin.

It has been approved for those whose cancer has returned or not responded to at least two treatments, and only if they have previously had polatuzumab vedotin or it is contraindicated or not tolerated.

DLBCL is an aggressive blood cancer, with nearly 5,500 new diagnoses in the UK each year, according to figures from the charity Lymphoma Action.

Research suggests that, for around 700 of these patients, whose cancer has either returned or not responded to two other treatments, prognosis can be poor.

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The NICE recommendation is based on trial data that demonstrated a 62% overall response rate, meaning 62% of participants’ cancer either went down by half or showed no evidence of disease from tests and scans.

For the latter, there was no evidence of disease from tests and scans in 39% of these hard-to-treat patients, who on average had already been through three types of treatment before the trial.

Lauran Cooper, a support nurse at the charity Blood Cancer UK, welcomed the approval of a new treatment option by NICE.

“For those living with the blood cancer DLBCL it can be an emotional rollercoaster, with some people struggling with the symptoms of the disease, the side effects of treatments the uncertainty of what the future might bring,” she said.

“Around 700 people with DLBCL a year don’t respond to two previous treatments, and some can be left with palliative care as the only option.”

She added: “Research and innovation is vital if we are to beat blood cancer – the UK’s third-largest cancer killer.

“New drugs like Tepkinly for DLBCL that are readily available on the NHS will give people with blood cancer hope that they’ll be able to spend more time doing the things they love.”

Professor Chris Fox, from Nottingham University Hospitals NHS Trust, said that, despite recent advances, treatment options for this “hard-to-treat group of patients have been limited”.

He highlighted that the decision by NICE provided clinicians with a second bispecific antibody treatment option for eligible patients and the first that was given as a subcutaneous injection.

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“Epcoritamab is the first bispecific to be given as a subcutaneous injection that gives patients and clinicians an additional choice of administration option, which may help to support capacity planning within lymphoma services.

“The decision by NICE will be welcomed by both patients and the clinical community,” he added.

Another bispecific antibody, glofitamab (Columvi), which is manufactured by Roche, was approved for the same indication by NICE in October last year.

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