16th January 2023

Two new lung cancer treatments approved in Scotland

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The Scottish Medicines Consortium (SMC) has today [Monday 16th January] approved two new targeted therapies for lung cancer patients in Scotland.

Tepotinib, which is already approved for patients in England, will now be available to people with advanced non-small cell lung cancer harbouring mesenchymal-epithelial transition factor gene (MET) exon 14 (METex14) skipping alterations. The approval comes after a phase II single-arm study saw a 51 percent response rate to the treatment.

Patients with epidermal growth factor receptor (EGFR) exon 20 insertion mutation-positive locally advanced or metastatic non-small cell lung cancer will now be able to receive the second approved therapy, Mobocertinib. 28 percent of patients who had been previously treated with platinum-based chemotherapy achieved a confirmed objective response.

The National Institute for Health and Care Excellence approved the use of Mobocertinib for patients in England at the beginning of the year.

Paula Chadwick is the chief executive for Roy Castle Lung Cancer Foundation:

“It is fantastic to start the new year with two more treatments available for patients. Although we are not talking about huge numbers of people who will be eligible for these therapies, having new treatment options is so impactful.

“For those who meet the criteria, it offers peace of mind that another treatment line is there for them if and when they need it, whilst for those who don’t qualify this time, it gives hope that new treatments are constantly evolving.

Paula Chadwick

“The announcement also sparks calls to ensure everyone diagnosed with lung cancer has a routine biopsy to see if there are any mutations, and also to re-biopsy the tumour when it starts to re-grow. The results may give us the opportunity to offer a more effective treatment, one that might not have been suitable originally, or not been available at that time.”

What is a biopsy?

A biopsy involves taking a small sample of the tumour, or fluid from it so that it can be examined and tested for cancer and mutations. This is called molecular analysis.

Doctors will use a local anaesthetic to numb the skin on either your chest or back. A thin needle is then passed through the chest wall and into the lung cancer. A CT scanner is then used to guide the needle to take the sample.

The procedure may be a little uncomfortable but it only takes a few minutes. You will then need to stay in the hospital for a few hours after for monitoring.

For most people, the biopsy and molecular analysis will happen before any treatment. For some people who have surgery, tests may be carried out on the cancer removed during the operation.

If you have already had treatment for lung cancer and it has come back, a further biopsy may need to be done. This is because, when lung cancer comes back, it may have changed to a different type or subtype.

People whose tumours test positive for these mutations, and who have been given matched targeted treatments, often gain more benefit than from standard chemotherapy or immunotherapy, though they may also receive these treatments later. This detailed testing of the biopsy is to make sure the treatment you receive is the one that is most effective for you.