The National Institute for Health and Care Excellence (NICE) has recommended pembrolizumab in combination with chemotherapy (paclitaxel or nab-paclitaxel) (Injectable immunotherapy treatment) which is said to benefit people with triple negative breast cancer.

Clinical trial evidence shows that, compared with paclitaxel, pembrolizumab combination increases how long people have before their cancer gets worse and how long they live.

NICE already recommends atezolizumab in combination with chemotherapy for untreated PD-L1-positive, locally advanced or metastatic, triple-negative breast cancer. Atezolizumab combination is recommended by NICE for people with IC equal to or greater than 1%.

“This means that some people who can’t have atezolizumab combination could be eligible for pembrolizumab combination,” said NICE.

NICE’s independent appraisal committee also agreed that the pembrolizumab combination meets the higher cost-effectiveness threshold for life-extending treatments for people with a short life expectancy.

Given by injection every 3 weeks, pembrolizumab (also called Keytruda and made by Merck Sharp and Dohme) is a type of immunotherapy that specifically targets triple negative breast cancer. It works by blocking the activity of a protein known as PD-L1 which is produced in larger amounts on cancerous cells than normal cells. By blocking PD-L1 it helps the person’s own immune cells to attack the cancer.

Helen Knight, interim director of medicines evaluation at NICE, said:“Today’s decision demonstrates how NICE is at the forefront of bringing better care to more people. I am pleased the company has been able to work constructively with us to find solutions to the issues highlighted in our previous draft guidance.

“People who were not able to access atezolizumab, another NICE-recommended immunotherapy, now have an important new option that can help them live longer and spend more precious time with their loved ones. So, although our recommendation is for a narrower population than pembrolizumab combination is licensed for, it means the maximum number of people with advanced triple negative breast cancer now have access to effective treatments.”

The draft guidance on pembrolizumab combination for advanced triple negative breast cancer is available here. 

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