MSD (tradename of Merck & Co., Inc., Rahway, N.J., USA (NYSE: MRK)) announced today that the Scottish Medicines Consortium (SMC) has accepted the use of KEYTRUDA® (pembrolizumab) for use within NHS Scotland in combination with carboplatin and paclitaxel (chemotherapy) for the first-line treatment of primary advanced or recurrent endometrial carcinoma in adults.
This includes patients with mismatch repair proficient (pMMR) tumours and mismatch repair deficient (dMMR) tumours.
Endometrial carcinoma – the most common type of womb cancer – is the most prevalent of the five gynaecological cancers, and the fourth most common cancer among women in the UK.
802 cases were diagnosed in Scotland between October 2022 and September 2023. Most people who develop endometrial carcinoma are post-menopausal.
If diagnosed early (stages 1-2), survival of endometrial carcinoma is generally good, with over 75% of those diagnosed with endometrial carcinoma surviving for 5 years or more. However for patients with advanced or recurrent endometrial carcinoma – where the cancer is at stage 3 or 4 – the rate of 5-year overall survival can be 50% or less.
In cancer, dMMR and pMMR refer to how well a cancer cell’s DNA repair system works. dMMR means the repair system is not working correctly which leads to errors in the DNA, while pMMR means the repair system is working as it should. Patients with dMMR tumours represent approximately 25-30% of endometrial carcinoma cases, with pMMR tumours accounting for the remaining 70-75% of cases.
Until now, chemotherapy in combination with immunotherapy was a first-line treatment option for endometrial carcinoma patients with dMMR tumours, but not those with pMMR tumours.
The SMC’s latest decision offers an additional choice to patients with pMMR tumours for whom there have previously been limited treatment options, by offering a first-line treatment option combining pembrolizumab with carboplatin and paclitaxel for the treatment of primary advanced or recurrent endometrial carcinoma in adults with either pMMR or dMMR tumours.
Dr Eleanor Jones, Chair of Trustees at Peaches Womb Cancer Trust, said:
“Today’s decision is very welcome news for patients living in Scotland. We hope that this is just the first step towards wider availability of more effective first-line treatment options for those affected by womb cancer.
“This additional treatment for primary advanced or recurrent mismatch repair proficient and deficient endometrial cancer will provide much needed options for patients currently facing the reality of limited cancer treatments.
“Peaches Womb Cancer Trust has welcomed the opportunity to contribute to appraisals in both Scotland and England. We could not have done so without the contributions of Peaches Patient Voices, a group of people affected by womb cancer whose powerful testimonies and experiences informed our submissions.”
Benson Fayehun, Head of Oncology at MSD in the UK, said:
“With the number of cases of endometrial carcinoma in Scotland between 2022 and 2023 showing an increase on previous years, today’s decision from the SMC shows how Scotland is leading the way in widening access to an alternative treatment for patients living with primary advanced or recurrent endometrial carcinoma with either dMMR or pMMR tumours – with the latter community previously being a particularly underserved population.
“We are committed to working with NICE to make this treatment available for patients with primary advanced or recurrent endometrial carcinoma across other UK nations.”
