Charity welcomes Scotland’s approval of treatment on the NHS for children with rare brain tumours

Children in Scotland diagnosed with a brain tumour that has a specific genetic mutation can now be treated on the NHS with a kinder, more effective targeted therapy. 

The Scottish Medicines Consortium has today approved prescribing dabrafenib to treat children aged one and above who have been diagnosed with a low- or high-grade glioma that has the BRAF V600E mutation: https://scottishmedicines.org.uk/medicines-advice/dabrafenib-finlee-full-smc2667/

It’s used in combination with another medicine, trametinib, and both can be administered at home as they are taken orally. This means fewer hospital visits. 

The news follows the approval given in April this year by the National Institute for Health and Care Excellence (NICE). 

Current standard treatment for the condition typically involves surgery – where that’s possible – chemotherapy and/or radiotherapy. But less than 30% of children diagnosed with high-grade gliomas survive for five years or more and the treatment often has brutal side effects.  

Outcomes for low grade gliomas – the most common childhood brain tumour – are better at a 90% survival rate following surgery. But chemotherapy may also be prescribed whereas this treatment means improved quality of life for patients as clinical trials showed its side effects were rare.  

The combination medication is the first targeted treatment to be made available on the NHS for paediatric gliomas. It is already licensed for use in the USA, and for use in the UK in adults with the BRAF mutation who have some types of lung and skin cancers. 

The two drugs work together to block the growth signal coming from the mutant BRAF protein, slowing or even stopping the tumour from growing.  

Brain tumours affect around 500 children a year in the UK, of whom between 150 to 175 may have a glioma and fewer still will have the BRAF mutation. But despite the small numbers involved, this is the first progress made in treating the disease in years. 

In 2008, research carried out by Dr David Jones which was funded by The Brain Tumour Charity (then known as the Samantha Dickson Brain Tumour Trust), identified a BRAF mutation that was common in pilocytic astrocytoma brain tumours. 

This was the first time that a specific genetic change had been detected in these tumour types and it paved the way for drug development as it could then become a target for diagnostic tests, changing the research landscape for low grade brain tumours in children. 

Dr Jones now leads the EVEREST Centre in Germany, which carries out research into paediatric low grade brain tumours. 

Dr Michele Afif, Chief Executive at The Brain Tumour Charity, said: “We are delighted that the Scottish Medicines Consortium has joined NICE in approving the first new treatment for paediatric brain tumours in decades.

“We hope that this will be the first of many new treatments that will ensure our community can live longer and better lives.” 

To find out more about The Brain Tumour Charity, visit:

www.thebraintumourcharity.org/]www.thebraintumourcharity.org/ 

Scotland approves two new blood cancer drugs

Two new drugs for diffuse large B-cell lymphoma (DLBCL) have been made available by the Scottish Medicines Consortium (SMC) for use on the NHS in Scotland as a third-line treatment.

Tepkinly (epcoritamab), and Columvi (glofitamab) will be available for use in patients with relapsed or refractory DLBCL after two or more lines of systemic therapy.

Previously, NICE approved Tepkinly and Columvi for use on the NHS in England and Wales for people with DLBCL who’s disease had not responded to at least two previous treatments.

DLBCL is a type of non-Hodgkin lymphoma, which develops in the lymphatic system. Around 5,500 people a year are diagnosed with this form of blood cancer in the UK. And for around 700 of those people, their disease won’t respond to two previous treatments.

Tepkinly is a drug, manufactured by Abbvie, while Columvi is manufactured by Roche. They are both bispecific antibodies designed to recognise and attach to the cancer cells and immune cells, so that the body’s immune system can destroy them.

Josh Hill, Blood Cancer UK’s Scottish policy officer said: “Diffuse large B-cell lymphoma (DLBCL) is a type of blood cancer and while most people go into remission after standard treatment, some people can see their cancer return or stop responding to treatment.

“Today’s decision by the SMC to approve epcoritamab and glofitmab for use on the NHS in Scotland is a welcome step for many.

“Like many that experience blood cancer, people with relapsed or refractory DLBCL experience anxiety around the prospect of not responding to treatment or the cancer once again returning. Advances in bispecifics is set to be an active area of research and drug development in coming years.”

Dr Andrejs Ivanovs, consultant haematologist at the Edinburgh Cancer Centre, said: “The clinical evidence from drug trials using bispecific antibodies including epcoritamab and glofitimab is positive.

“These drugs are incredibly useful as they’re available ‘off-the-shelf’ meaning drugs can be used without delay for lymphoma patients who did not have a lot of success with other treatments. 

“Bispecific antibody treatments usually do not require a hospital admission and can be administered in day units and can achieve response in about 50-60% of patients. This is likely to prolong survival rates for people with blood cancer here in Scotland, and that’s exactly what people with blood cancer deserve.”

Aileen Lamb, from Edinburgh whose now in remission from blood cancer said:
“As someone who’s been through blood cancer treatment, I am thrilled that the SMC have given full approval for use of epcoritamab and glofitmab to treat diffuse large B-cell lymphoma in Scotland.

“This is important for the whole blood cancer community and gives us hope for our future.”