METUPUK welcomes the Scottish Medicines Consortium (SMC) decision to accept pembrolizumab (Keytruda, Merck Sharp and Dohme) plus chemotherapy (paclitaxel or nab-paclitaxel) for use on the NHS in Scotland.  Pembrolizumab is indicated for treating triple-negative, locally recurrent unresectable or metastatic breast cancer in adults whose tumours express PD-L1 with a CPS ≥ 10 and who have not received prior chemotherapy for metastatic disease.

Metastatic triple negative breast cancer (mTNBC) is a challenging disease to treat, and an even more devastating disease to live with.  It is an aggressive subtype which is more prevalent in younger premenopausal women and black and Hispanic women.  The median survival is just 12-18 months, cutting the lives of patients short often by many decades.  Metastatic triple negative breast cancer also has fewer treatment options than other breast cancer subtypes because it cannot be treated with targeted hormonal or anti-HER2 therapies.

Pembrolizumab 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.  Around 20% of patients with TNBC over express PD-L1, and for this subset of patients the SMC already recommends atezolizumab in combination with chemotherapy.  The approval of pembrolizumab now gives oncologists an additional option to treat this devastating disease.

METUPUK patient advocate Katy Lusardi responded to the SMC approval: I am encouraged to hear that some patients living with mTNBC in Scotland will now have access to pembrolizumab.  mTNBC is a very aggressive disease, the most aggressive type of breast cancer and it’s imperative that patients have more drug options to help us extend our lives.  These are people’s daughters, mothers and sisters and we deserve more hope with a better quality of life and more time with our loved ones.

Jo Taylor, founder of METUPUK commented: “This drug authorisation is a significant step forward for patients living in Scotland with metastatic triple negative breast cancer that over expresses PD-L1.  Pembrolizumab addresses an important unmet need because it increases how long people have before their cancer gets worse and how long they live.  Patients with triple negative breast cancer often tell us that the wait time for PD-L1 testing at the beginning of their diagnosis is incredibly stressful.  At METUPUK we call on increased investment in pathology services to ensure that patients get the rapid test results needed to commence their first line treatment.”

We welcome that pembrolizumab plus chemotherapy is now available across the whole of the UK to patients with mTNBC who will benefit from it.  As a high income country, the public expect the NHS to fund innovative cancer treatments.  Restrictive drug access contributes to UK cancer survival comparing poorly to similar income countries.

Thank you to Lesley Stephen METUPUK advocate and Scottish metastatic breast cancer patient for supporting this application with the SMC.

Improved drug access allows us to stay #BusyLivingWithMets and increase our survival outcomes.

We demand change.