Two new targeted cancer drugs funded in agreement

PHARMAC is funding two new targeted cancer medicines following an agreement with GlaxoSmithKline.

From 1 April 2012 PHARMAC will begin funding lapatinib (Tykerb) and pazopanib (Votrient). These two new orally administered treatments are designed to specifically target cancer cells.  Lapatinib is used in patients with advanced, HER2 positive  breast cancer, and pazopanib in advanced kidney cancer patients. Both will be funded as alternatives to the currently funded treatment options; trastuzumab (Herceptin) for advanced HER 2 positive breast cancer patients and sunitinib (Sutent) for advanced kidney cancer patients.

PHARMAC medical director Dr Peter Moodie says that in addition to expanding the range of treatment options available, both new treatments are pills that patients can take at home.

“The funding of lapatinib in particular will make treatment more convenient for those breast cancer patients who choose to receive it instead of trastuzumab, because it avoids the need for them to go to hospital every 3 weeks for infusion treatments,” says Dr Moodie. “It also means that if patients choose lapatinib rather than trastuzumab DHB hospitals will have additional capacity for treating cancer patients, which will help reduce waiting times for cancer treatment, one of the Government’s key health targets.”

As well as being taken in pill form, lapatinib is a smaller molecule than trastuzumab which means it can pass through the `blood/brain barrier’ – which may be an important factor in deciding the best treatment option for patients with advanced disease.

“The features of lapatinib make it a useful addition to funded treatment options. We know from the studies that it has a similar mode of action to trastuzumab, and it is effective in delaying the progression of HER 2 positive metastatic breast cancer, as is trastuzumab.”

Dr Moodie says that although targeted treatments generally have fewer side effects than standard chemotherapy treatments they do have their own toxicity issues, some of which can be serious.   The funding rules for these treatments mean that, if patients experience early side effects on their first choice treatment, then they can have access to funding for the alternative treatment.

Pazopanib is the second targeted oral cancer treatment funded for metastatic renal cell carcinoma, following the funding of sunitinib (Sutent) in 2010. While both drugs have similar modes of action and appear to have similar benefits for patients, Dr Moodie says having an alternative treatment is useful in patients who experience early toxicity.

PHARMAC estimates that up to 180 patients per year will receive pazopanib or lapatinib, and that spending on the two drugs will be in the region of $15 million over five years. However, because of the drugs’ net cost compared with the currently funded treatment options for these patients overall the decision is cost-saving to DHBs.