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October 2016 decisions news release

New treatments for thyroid cancer and lung cancer among five medicines accepted for routine use by NHS Scotland. 

The Scottish Medicines Consortium has today (Monday 10 October) published advice accepting five new medicines for routine use by NHS Scotland. Two of these medicines, lenvatinib (Lenvima) for advanced thyroid cancer and nivolumab (Opdivo) which can be used to treat a type of lung cancer, were accepted after consideration through the Patient and Clinician Engagement (PACE) process for medicines that treat end of life and very rare conditions.

Lenvatinib is used to treat thyroid carcinoma (a rare cancer). It is used when the cancer has spread to other parts of the body and does not respond to conventional treatment with radioactive iodine. PACE participants spoke of how life expectancy can be significantly reduced for these patients. Lenvatinib may improve progression-free survival compared to existing treatment and is also associated with a different side-effect profile which some patients may find more manageable.  It has the potential to offer patients the opportunity to retain or regain a good quality of life. 

Nivolumab was accepted for the treatment of a type of lung cancer known as non-squamous non-small cell lung cancer (NSCLC).  In the PACE meeting, patient groups and clinicians highlighted that patients tend to be diagnosed with late stage disease and often have a poor prognosis. Nivolumab can offer patients around three months extra survival time and the potential for improved quality of life, which is very valuable in the context of a limited expected overall survival time of around eight months.  

Aflibercept (Eylea) is used to treat a severe type of visual impairment which can lead to loss of sight. A patient group submission from RNIB Scotland noted that the condition often develops in those in the 40–60 year age group, who may have significant family and work commitments. Aflibercept can help slow sight loss and offers an alternative treatment option for patients and clinicians.

Budesonide (Cortiment) was accepted for the treatment of ulcerative colitis, a condition that causes inflammation and ulceration of the inner lining of the colon. It offers an alternative oral treatment for this condition. 

Also accepted was progesterone (Lutigest), which can be used to support embryo implantation and early pregnancy as part of infertility treatment. 

SMC chairman Professor Jonathan Fox said:

“I am pleased the Committee was able to accept these five medicines for routine use by NHSScotland. The evidence presented by patient groups and clinicians during PACE meetings made it clear that lenvatinib for thyroid cancer and nivolumab for non-squamous NSCLC will be welcomed by patients and their carers as these medicines may offer patients improved survival with a better quality of life. 

“New treatments for sight loss and ulcerative colitis are also welcome, as is an additional option for use in the treatment of infertility.”