Vizimpro recommended on NHS for NSCLC – NICE

Research into early signs of lung cancer spread

Life-extending lung cancer treatment, Vizimpro recommended on NHS as a first-line treatment for non-small-cell lung cancer.

Dacomitinib (Vizimpro, Pfizer) has been recommended as a first-line treatment option for people with a type of non-small-cell lung cancer (NSCLC), in new National Institute for Health and Care Excellence (NICE) guidance published today.

This once-a-day pill will be available on the NHS for adults with locally advanced or metastatic NSCLC, that has tested positive for the epidermal growth factor receptor (EGFR) mutation. This is a change from the committee’s initial decision which found dacomitinib to not be a cost-effective use of NHS resources.

According to company estimates around 1,477 people will be eligible for this treatment annually.

Clinical trial results showed that people who took dacomitinib had longer overall survival rates than those who took gefitinib (34.1 months compared with 26.8 months), a drug already recommended by NICE. Dacomitinib also increased the length of time before the disease worsened (14.7 months for dacomitinib compared with 9.2 months for gefitinib). It was, however, noted that dacomitinib had a higher incidence of side effects than gefitinib, so a lower dose may be needed.

Meindert Boysen, Director of the Centre for Health Technology Evaluation at NICE, said: “Our committee acknowledged that dacomitinib had the potential to extend life for people with this type of lung cancer more than existing treatments currently available on the NHS.

“Responsible pricing by the company has allowed our committee to reconsider their initial decision. This has led to the positive recommendation announced today, allowing patients to benefit from this innovative treatment on the NHS.”

Dacomitinib is a tyrosine kinase inhibitor that targets the EGFR mutation to kill the cancerous cells and prevent them from replicating. NICE has already recommended three other drugs of this type for untreated EGFR-positive NSCLC: afatinib; erlotinib; and gefitinib.

The list price of dacomitinib is £2,703 per pack of 30 capsules. The company has a commercial arrangement which makes dacomitinib available to the NHS with a confidential discount.

Olivia Ashman, Oncology Medical Director, Pfizer UK said: “We welcome NICE’s decision to recommend dacomitinib for the first-line treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR-activating mutations. Lung cancer remains a challenging condition to treat and we are pleased that clinicians managing patients with EGFR-mutated NSCLC will now have access to this important medicine.”

Separately, NICE has also today published guidance that does not recommend osimertinib (Tagrisso, AstraZeneca) in the same patient population because the cost effectiveness estimates were above what NICE normally considers to be an acceptable use of NHS resources.