We are very pleased to announce that NICE has approved the Bayer drug Larotrectinib (Vitrakvi) for use via the Cancer drug fund (CDF) in England for adults and children who have failed other treatment options and whose tumours test positively for the rare NTRK fusion (Neurotrophic Tyrosine Receptor Kinase fusion).
Described as an histology agnostic or independent treatment it can be used across many different types of cancer where the driving mutation is found to be an NTRK Fusion and it heralds a new era in personalised treatments for patients.
Patients whose tumours are driven by an NTRK fusion and where surgery is not curative have, until now, not had any satisfactory treatment options. Being able to access this drug via the CDF is a huge benefit to patients and the reason it is such a landmark decision is that small patient numbers have made it difficult to collect the vast quantities of data usually needed for such a decision. Progressing this way means that the NHS will pay for the drug for a time while more data is collected to demonstrate cost and treatment effectiveness so that it can be available permanently.
In recent years we have been hearing that some GIST cancer patients harbor an NTRK fusion mutation and that patients currently classified as Quadruple negative GIST (because they lack mutations in the four genes KIT, PDGFRA, SDH or BRAF) should be tested to see if they have the NTRK fusion mutation.
The approval of Larotrectinib on the CDF is timely in that it coincides with the start of the roll-out of genomic testing in England, which once the Corona pandemic has settled down, will concentrate at first on rare and childhood cancers.
CDF drugs are usually available to patients in Wales & N. Ireland via country specific funding routes. Larotrectinib is not yet available in Scotland.
The PAWS-GIST clinic at Addenbrookes hospital in Cambridge www.pawsgistclinc.org.uk is working to test Quadruple negative GIST patients who have attended the clinic, for the NTRK fusion.
Dr V.Ramesh Bulusu – Leading GIST Oncologist and Clinical lead for the PAWS-GIST Clinic said:
“NTRK Fusion GISTs are very rare and currently there is no standard of care. We need to start testing all our quadruple negative GIST patients for this NTRK fusion, working together to identify the patients and get them on to the treatment”.
The link below will take you to more information from NHS England.