Crizotinib and osimertinib listed on PBS for lung cancer

Lung cancer

By Michael Woodhead

21 Jan 2019

Crizotinib (Xalkori) is now available through the PBS for lung cancer patients with a c-ROS proto-oncogene 1 (ROS1) gene rearrangement.

From 1 January the drug is subsidised for patients with Stage IIIB (locally advanced) or Stage IV (metastatic) non-small cell lung cancer.

And from 1 February, osimertinib (Tagrisso) will be listed on the PBS for the treatment of epidermal growth factor receptor (EGFR) T790M mutation positive NSCLC, the government has announced.

The listing follows a recommendation by the by the Pharmaceutical Benefits Advisory Committee that osimertinib provides, for some patients, a significant improvement in efficacy and a reduction in toxicity over platinum-based doublet chemotherapy

The EGFR mutation test for the presence of the T790M mutation is also funded on Medicare for patients with locally advanced (Stage IIIB) or metastatic (Stage IV), non-squamous or not otherwise specified EGFR mutation positive non-small cell lung cancer, who have received first-line epidermal growth factor receptor tyrosine kinase inhibitor (EGFR TKI) treatment, and whose disease has subsequently progressed.

At its November meeting the PBAC also advised the health minister and the federal health department to consider a broad PBS subsidy listing for PD-(L)1 inhibitors for non-small cell lung cancer (NSCLC.)

The committee said there was substantial evidence and experience available for four PD-(L)1 medicines (atezolizumab, durvalumab, nivolumab and pembrolizumab) in this setting.

“The PBAC considered there is potential for a NSCLC listing that allows patients of WHO performance status 0 and 1 access to a single course of treatment with a PD-(L)1 inhibitor, irrespective of disease stage (unresectable stage III or IV), biomarker status, line of treatment (adjuvant, 1st or later line), and with or without concomitant cytotoxic therapy,” its statement said.

“This would allow the decision regarding timing the PD-(L)1 inhibitor to be determined by the clinician and patient.”

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