The National Cancer Control Programme has announced that four new drugs are being made available in hospitals across the country to treat cancer.
The new medications will be used to fight bone cancer in children and younger adults, skin cancer, advanced prostate cancer and renal cancer.
The HSE estimates the new drugs will benefit over 230 patients this year and will cost the state around 3.5 million euro.
The four drugs are Cabazitaxel (Jevtana®), Vemurafenib (Zelboraf®), Axitinib (Inlyta®) and Mifamurtide (Mepact®).
Cabazitaxel (Jevtana®) is a chemotherapy drug used in combination with the steroid prednisone to treat men with prostate cancer. It will be used to treat men with advanced, hormone-refractory, prostate cancer that has worsened during or after treatment with Docetaxel, a commonly used drug for advanced prostate cancer.
Prostate cancer is the most common invasive cancer in Ireland after skin cancer. Over 2,700 men are diagnosed with prostate cancer each year and there are approximately 500 deaths from prostate cancer each year in Ireland. Most cases occur in men over 50 years of age.
The aim of treatment for hormone resistant prostate cancer (HRPC) is to alleviate symptoms, prolong life and slow progression of the disease. Cabazitaxel’s safety and effectiveness was established in a single, 755-patient study. The median overall survival for patients receiving the Jevtana regimen was 15.1 months compared with 12.7 months for those who received the comparison regime
Prior to 2012, there was no approved agent and few options for the treatment of patients who had this specific type of advanced prostate cancer. However, since December 2012, patients have had access to Abiraterone (Zytiga) and now have access to Cabazitaxel - after failure of Docetaxel.
It is estimated that a total of 22 patients will be treated with Cabazitaxel in 2013 increasing gradually on an annual basis to 34 in 2016.
The initial annual cost of the drug is anticipated to exceed €800,000 in the first year and is anticipated to rise to over €1m by 2017.
Vemurafenib (Zelboraf®) is a new drug used in the treatment of melanoma (skin cancer) that cannot be removed by surgery or has spread to other parts of the body. Vemurafenib is a kinase inhibitor. It works by preventing the growth of cancer cells. It is used in patients with aggressive melanoma who have a specific mutation of the BRAF gene in their cancer cells. This new drug improves survival from a median of 9.9 months with an old drug, Dacabazine, to 13.2 months. It is anticipated that 30 patients will be treated annually with Vemurafinib with that number increasing to almost to 50 by 2015.
It is estimated that the annual cost of the drug will be in excess of €1.5m based on existing projections.
Approval for the introduction of Vermurafinib comes over 10 months after the drug Ipilimumab - also designed to treat skin cancer - was introduced. Both drugs represent a significant advance in the treatment of melanoma. Axitinib (Inlyta®) is a new drug used in the treatment of renal cell carcinoma, a kidney cancer.
Kidney cancer is a relatively rare disease which usually presents in latter years. It accounts for 2.5% of all malignant cancers in Ireland. Eighty five of these cases present as Renal Cell Cancer.
On average, 434 kidney cancers were diagnosed annually in Ireland from 2007 to 2009 and the majority of those diagnosed are aged over 60. Axitinib has been shown to increase survival by two months to a median of 6.7 months compared with another drug Sorafenib, in patients with advanced cancer which has progressed on other drugs.
It is anticipated that about 174 people will receive this drug annually each year at a cost exceeding €500,000.
Mifamurtide (Mepact®) has been approved for use in osteosarcoma, the most common primary malignant tumour arising in bone.
Osteosarcoma is a type of bone cancer which affects mainly affects children and young adults. It most commonly presents in second decade of life and can be fatal in about a third of cases. An average of ten adults and three children under the age of 18 are diagnosed with osteosarcoma each year. It is used in the treatment of newly diagnosed patients being treated with curative intent.
Mepact has been studied in one main study involving 678 patients aged less then 31 years old with high grade non metastatic osteosarcoma. After surgery to remove the cancer, all of the patients were given various combinations of anti cancer medicines. Half of the patients were also given Mepact. The study compared patients who were given Mepact and those who were not. The main measure of effectiveness was the number of patients who survived without the disease coming back. The patients were followed up for 10 years.
Mepact, used with other anticancer medicines, increased how long patients survived without their disease coming back : 68% of the patients receiving Mepact (231 out of 338) survived without the disease coming back, compared with 61% of the patients who did not receive it (207 out of 340). The risk of dying was also reduced by 28% in patients receiving Mepact.
It is anticipated that less than 10 patients each year will be treated and the budget impact is expected to be in excess of €800,000 annually.
