New treatment for Australia’s deadliest cancer
Exclusive: A HIGH-cost new combination therapy for Australia's deadliest cancer has been approved for subsidy saving lung cancer patients $15,000 every three months.
The treatment which combines high cost immunotherapy Keytruda with chemotherapy has been shown to dramatically improve five-year survival rates in non-small cell lung cancer patients from just 5 per cent to almost 25 per cent.
New South Wales' Westmead Hospital cancer expert Dr Rina Hui's research has found combining chemotherapy with immunotherapy dramatically improves survival compared to using either treatment alone.
Keytruda works best in patients who have higher levels of a marker called PD-L1 (programmed death-ligand) that suppresses the immune system and stops it fighting cancer cells.
Thirty per cent of these patients will survive beyond five years.
However, Dr Hui has found when you combine the immunotherapy with chemotherapy in patients with low levels of PD-L1 patients have a dramatic increase in survival.
"The cancer tricks the immune system to present as normal and we take off the blindfold so the immune system realises it's the bad guy," she explained.
Patients treated with the Keytruda/chemo combo survived 22 months, compared with only 11 months for patients treated with chemo alone - therefore the combination of Keytruda and chemo doubled life expectancy.
"It would be great if the PBAC followed the science to offer patients the best possible treatment," Dr Hui said.
There are side effects from the treatment with one in 12 patients suffering hyperthyroidism, one in 16 patients suffering overactive thyroid and 2 per cent experiencing swelling of the lungs. Some people also suffer immune toxicity.
While the drug has been recommended for subsidy for patients with stage IV non-small cell lung cancer the pharmaceutical company that makes it must now negotiate a price with the government, a process that can take months.
"MSD is committed to working in partnership with the Australian Government to ensure that eligible Australian patients have timely access to this treatment option through the PBS," the company said.
The success of the treatment is leading scientists to rethink how you define a cancer cure.
This is because many patients treated with Keytruda still have tiny amounts of cancer in their bodies but it does not appear to progress or spread.
"I believe our immune system in tight regulation keeps a close check on the cancer and tries to keep it under control and you achieve equilibrium so it doesn't increase or decrease," Dr Hui said.
There are now four immunotherapies approved for subsidy in Australia - Opdivo, Tecentriq, Bavencio and Keytruda.
In November last year the government approved for subsidy another immunotherapy combination treatment using Tecentriq, Avasatin and chemotherapy.
Lung cancer is Australia's deadliest cancer killing more than 9000 Australians each year, more than breast and bowel cancer combined.
Around 10,000 Australians will this year be diagnosed with non-small cell lung cancer and could potentially benefit from the new treatment combination.
Immunotherapies can be used in a wide range of cancers but have so far been subsidised for only a few type and less than 7000 Australian cancer patients received them.
They are subsidised for use in treating melanoma, advanced non-small cell lung cancer,
head and neck cancer, urothelial carcinoma, renal cell carcinoma, classical Hodgkin's lymphoma, hepatocellular carcinoma, primary mediastinal B-cell lymphoma and merkel Cell Carcinoma.
Great grandfather Graham McDean's lung cancer almost disappeared after he began combination treatment including Keytruda with chemotherapy in 2016.
After the cancer shrank his lung tumour from the size of a golf ball to the size of a marble the 81-year-old from Laurieton in New South Wales said his doctor told him without the treatment he would have "had no hope at all" of surviving.
"It's still shrinking, I feel good, my health is good and it's worked 100 per cent for me," Mr McDean said.
Mr McDean has now ceased all treatment but says tests show his cancer is under control.