The United Kingdom’s National Institute for Health and Care Excellence (NICE) recently recommended that three new blood cancer therapies be covered by the National Health Service (NHS) — Trisenox (arsenic trioxide), Rydapt (midostaurin) and Adcetris (brentuximab vedotin).
While Trisenox and Rydapt are recommended for adults with leukemia, Adcetris is recommended for the treatment of a specific type of lymphoma.
Developed by Seattle Genetics, Adcetris is an antibody-drug conjugate that specifically targets CD30, a protein expressed by certain cells called Reed-Sternberg cells that characterize classical Hodgkin’s lymphoma. Adcetris contains a toxic molecule called monomethyl auristatin E, which leads to cell death upon specific release in cancer cells.
In the U.K., the therapy had been made available to people through the Cancer Drugs Fund for the past five years. With this NICE recommendation, about 45 more people a year with CD30-positive Hodgkin’s lymphoma will now have automatic access to the therapy.
Adcetris was approved in the United States in March for use in adults with previously untreated stage 3 or 4 classical Hodgkin’s lymphoma.
FDA approval was based on positive results of a Phase 3 clinical trial (NCT01712490) called ECHELON-1, which compared a combination of Adcetris with chemotherapy to the standard Hodgkin’s lymphoma chemotherapy regimen.
Results of the randomized study, which included 1,334 participants, showed that, after two years, 82.1 percent of patients taking Adcetris were alive, progression-free, and had not required additional therapies.
These results translate to a 23 percent decrease in the risk of progression, death, or need for additional cancer therapy in patients who did not respond well to first-line treatment.
Patients receiving the Adcetris combination also exhibited less lung toxicity, which researchers suspect is because these patients did not receive Blenoxane (bleomycin), which is associated with lung damage, in their chemotherapy regimen.
Adcetris was linked to more cases of febrile neutropenia (low levels of neutrophils) and infections than the standard chemotherapy group, although researchers stressed that these complications can be treated with existing therapies.
Results from the ECHELON-1 study also led to the clearance of Adcetris for the treatment of adults with a type of non-Hodgkin’s lymphoma known as systemic anaplastic large-cell lymphoma.
“We are pleased that NICE and the drug’s manufacturers have worked together to secure access to brentuximab for future patients. This is extremely positive news and offers reassurance to people with Hodgkin lymphoma that they will be able to access the most appropriate therapies at every stage of their treatment. While standard treatments for Hodgkin lymphoma are generally successful, this decision enables doctors to give patients the best chance of a long-term cure if they do not respond to them,” Alasdair Rankin, director of research and patient experience of UK blood cancer charity Bloodwise, said in a press release.
Adcetris, along with the other two recommended therapies, should be available on NHS three months after NICE publishes its final guidance.
The European Commission approved Adcetris as a treatment for adults with cutaneous T-cell lymphoma whose cancer produces the CD30 molecule in January.
