SMC Makes Negative Recommendation for Abraxane, Treatment for Metastatic Pancreatic Cancer

Abraxane (paclitaxel formulated as albumin bound nanoparticles; nab-paclitaxel) in combination with gemcitabine, has not been recommended for use within NHS Scotland by the Scottish Medicines Consortium (SMC) for the treatment of metastatic pancreatic cancer, despite demonstrating a significant increase in overall survival when compared to the current standard of care, gemcitabine.[1,2]

Ms Alex Ford, Chief Executive of Pancreatic Cancer UK, on the SMC decision, said: “As a charity that speaks to patients and carers right across the UK on a daily basis, we are extremely disappointed by this decision especially as this treatment is available across the border in England. Given that most patients are diagnosed at a point when the disease is too advanced to treat, the negative SMC advice on Abraxane could potentially affect a significant number of patients with the disease each year.”

Currently, pancreatic cancer is the fifth most common cancer killer in the UK with almost 8500 people diagnosed each year.[3,4] In Scotland, survival rates for pancreatic cancer are similar to the rest of the UK with approximately one in six patients with advanced disease surviving for one-year after diagnosis.[5] Despite this, nab-paclitaxel in combination with gemcitabine, will not be made available through NHS Scotland for eligible Scottish patients as it is available for patients in England through the Cancer Drugs Fund (CDF).

In addition, around 80% of patients are diagnosed once the cancer has already reached an advanced stage, when a cure is no longer an option.[6] Five-year survival rates have not changed in 40 years[7] with metastatic pancreatic cancer affecting about 700 people in Scotland each year.[8]

Sam Pearce, Vice President and General Manager, Celgene UK & Ireland, said: “The decision by the SMC
not to recommend Abraxane, a life-extending treatment, is devastating news for anyone suffering from
metastatic pancreatic cancer in Scotland. We are committed to exploring all opportunities to ensure that
patients in Scotland can access this treatment and hope to re-submit to the SMC within the next few
months.”

References

[1] Goldstein D et al. Updated survival from a randomized phase III trial (MPACT) of nab-paclitaxel plus gemcitabine versus gemcitabine alone for patients (pts) with metastatic adenocarcinoma of the pancreas. American Society for Clinical Oncology Gastrointestinal Cancer Symposium (ASCO GI). Oral presentation. January 2014

[2] Celgene data on file. January 2014

[3] Mukherjee et al. Gemcitabine-based or capecitabine-based chemoradiotherapy for locally advanced pancreatic cancer. The Lancet Oncology 2013; 14(4): 317-326.

[4] British Medical Journal. Pancreatic adenocarcinoma. 334:e2476. Available at: www.bmj.com/content/344/bmj.e2476?variant=pdf. Published May 2012. Last accessed May 2014

[5] Pancreatic Cancer Action. UK Pancreatic Cancer Prognosis And Survival Rates https://pancreaticcanceraction.org/pancreatic-cancer/stats-facts/prognosis-survival/. Last accessed May 2014

[6] Pancreatic Cancer UK. Study For Survival 2011. www.pancreaticcancer.org.uk/media/100292/report_final_for_web.pdf Last accessed May 2014

[7] Pancreatic Cancer Research Fund. Cancer Facts and Figures. Available at: www.pcrf.org.uk/pages/cancer-table.html Accessed May 2014

[8] ISD Scotland: Cancer statistics: www.isdscotland.org/Health-Topics/Cancer/Cancer-Statistics/Pancreatic/ Last accessed May 2014