GI cancer

PBS listings for kidney, liver and bladder cancer drugs

A/Prof Niall Tebbutt

Three medications for bladder, liver and renal cancers will be listed on the PBS from 1 March.

The anti-PD-1 immunotherapy pembrolizumab (Keytruda) will become available for patients with locally advanced or metastatic urothelial cancer, the government has announced.

More than 430 patients a year are expected to be eligible for treatment with pembrolizumab as monotherapy for the treatment of locally advanced or metastatic urothelial carcinoma, where disease has progressed following platinum-containing chemotherapy and who have a WHO performance status of 2 or less.

The listing was welcomed by Associate Professor Andrew Weickhardt, an oncologist at the Olivia Newton-John Cancer Research Institute (ONJCRI) in Melbourne, who said there had been no new subsidised treatment options for advanced bladder cancer for many years, with treatment relying heavily on chemotherapy.

“[Pembrolizumab] is the first and only anti-PD-1 medicine to demonstrate a significant overall survival benefit compared to chemotherapy in a Phase III trial involving patients with locally advanced or metastatic urothelial carcinoma who had previously received platinum-based chemotherapy,” he said.

“This represents an important new treatment paradigm for patients with advanced urothelial carcinoma in whom the cancer has continued to metastasise following treatment,” he added.

“Bladder cancer is an area of significant medical need. It is one of just two cancers in Australia for which relative survival has actually decreased over time,” Associate Professor Weickhardt added.

Also PBS listed from 1 March is lenvatinib (Lenvima)  for patients with advanced hepatocellular carcinoma

The subsidy will make the drug available for about 618 patients, said Associate Professor Niall Tebbutt, director of the medical oncology unit at ONJCRI.

“I know from treating these patients that outcomes with liver cancer can be extremely poor and I think lenvatinib offers us a new treatment that’s certainly going to improve outcomes for patients,” he said.

“This is the first [new drug] in liver cancer for probably a decade. I’m very optimistic for the future – that lenvatinib is the first of a number of new treatments,” he added.

Also, combination therapy with nivolumab (Opdivo) and ipilimumab (Yervoy) will become available on the PBS for the previously untreated stage IV clear cell variant renal cell carcinoma. More than 300 patients a year will be able to access this treatment that would otherwise cost $254,200 per course of treatment, said Federal minister for health Greg Hunt.

The listing will provide a new and affordable first line treatment option for treating renal cell carcinoma, said Dr David Pook, medical oncologist at Cabrini Hospital, Melbourne.

“Most advanced kidney cancer patients have a poor prognosis, with less than 10% surviving for more than 10 years, as the cancer spreads to other parts of the body. Combination immuno-oncology therapy is an important new treatment option for kidney cancer patients,” he said.

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