Today the Scottish Medicines Consortium (SMC) has approved the use of a new drug, pembrolizumab (Keytruda), on the NHS to treat some patients with advanced cervical cancer. This is a big step forward as there has been a high unmet need in this area with bevacizumab (Avastin) being the only other targeted treatment available.

What is pembrolizumab?

Pembrolizumab is a type of targeted treatment called a monoclonal antibody that is already in use on the NHS to treat several different types of cancer, including non-small cell lung cancer or advanced triple negative breast cancer. It has provided hope for many cancer patients and is now available outside of a clinical trial or private health care in the UK for the first time.

Targeted drugs are important in cancer treatment because they target specific proteins that help cancer cells grow. The drugs can disrupt this process without impacting the function of other cells so, although they have some side effects, people tend to do well on them.

Until now, the only targeted treatment for advanced cervical cancer has been bevacizumab (Avastin) so we’re delighted that in Scotland, there is now another option available and we are calling for the other UK nations to follow suit. We are currently awaiting a decision from about whether it will be offered in England.

Is pembrolizumab available for everyone with advanced cervical cancer?

Pembrolizumab targets a protein called PD-1 on T cells, which are part of the immune system. PD-1 can join up with another protein, PD-L1, which can be found on cancer cells. In this way, pembrolizumab helps the immune system destroy the cancer cells. It is offered to women with advanced cervical cancer that has progressed after chemotherapy treatment who have a PD-L1 score of ≥1. It is given alongside chemotherapy (paclitaxel and either cisplatin or carboplatin) and may also be given alongside Avastin.

Find out more >

How effective is pembrolizumab?

The phase 3 trial (KEYNOTE-826) found patients who received pembrolizumab alongside chemotherapy with or without bevacizumab (Avastin) had longer before their disease progressed than those who only received chemotherapy with or without bevacizumab (Avastin). Overall survival was also longer for patients in the pembrolizumab group.

Why is pembrolizumab only available in Scotland?

After a drug has been through clinical trials and been shown to be safe and effective it is licensed, which means it can be prescribed for a specific use, for example for a certain cancer type and in conjunction with chemotherapy. In the UK it is also necessary to assess whether a treatment is suitable for use on the NHS, to ensure that NHS resources are used most effectively. Different independent organisations review drugs to see if they are suitable for prescribing on the NHS.

In Scotland, this is the SMC, in England the National Institute of Health and Care Excellence, the Northern Ireland Department of Health in Northern Ireland and the All Wales Medicine Strategy Group in Wales.

The committees look at the evidence and consult with clinicians, expert organisations and patient groups to help make their decision. Unfortunately, Pembrolizumab is not yet available in the rest of the UK. We will continue to campaign for the organisations above to make Pembrolizumab available for women living with advanced cervical cancer across the UK. NICE has also reviewed the use of pembrolizumab for advanced cervical cancer and we hope to hear their decision soon.

How has Jo’s helped make pembrolizumab available?

Jo’s has been campaigning for equal access to pembrolizumab and have been providing the patient voice to the SMC as part of their consultation. Find out more >

Thank you to all the women who shared their stories with us so we could present just how important new treatments are for women with advanced cervical cancer. A group who have been overlooked for far too long.

What does this mean for me?

Wherever you live, your oncology team will advise you on the most appropriate treatment for you. Scotland is the first country to make pembrolizumab available on the NHS. If you have questions about accessing pembrolizumab, wherever you live, your healthcare team will be able to support you.

We don’t want to see any inequality in access to cancer treatment, and are calling the other UK nations to follow Scotland as soon as possible.