herald

Thursday 22 November 2018

Doctors want more access to cancer treatment that is shrinking Vicky's tumours

Mum-of-two Vicky Phelan exposed the CervicalCheck scandal. Photo: Steve Humphreys
Mum-of-two Vicky Phelan exposed the CervicalCheck scandal. Photo: Steve Humphreys
Dr David Fennelly wants trial. Photo: Damien Eagers

Two leading oncologists are calling for wider access to a drug that cervical cancer sufferer Vicky Phelan says has reduced her tumours.

Ms Phelan, the Limerick mother-of-two who exposed the CervicalCheck scandal, announced the "significant shrinkage" in tumours after treatment with the drug Pembrolizumab.

Her cancer specialist, Dr David Fennelly, of St Vincent's Hospital, and his colleague, John Crown, now want more women with cervical cancer who have been assessed as having a particular marker making them suitable for the treatment, to have access to the drug.

However, it is expensive - costing around €5,000 to €6,000 a treatment.

The drug is currently not licensed in Europe for cervical cancer, although it is used in the treatment of other forms of the disease, such as melanoma, kidney and lung cancer.

Dr Fennelly told the Herald he is now anxious to set up a phase-two drug trial here to speed up the availability of the treatment to more women with cervical cancer.

"There is going to be huge pressure to get access to the drug, but under the normal regulatory mechanisms it could take three years and that is too long," he said.

Borrow

Although women who are among the 209 at the centre of the CervicalCheck scandal will be given the drug, other patients with the same disease are having to fundraise or borrow to try to purchase it because the HSE will not reimburse the cost.

The drug, made by Merck, works through a form of immunotherapy, where medication helps the patient's own immune system to attack cancerous cells, while leaving healthy cells unharmed. Dr Fennelly said patients whose tumours display the protein PD-L1 are potentially most likely to respond to the treatment.

A phase-two drug trial would test the drug on a large group of women.

Depending on the results, it could make it available more quickly than waiting for a phase three trial, where it is compared to existing treatment.

"The difficulty is that it is very expensive. It can cost 5,000 to €6,000 per treatment. A patient can need several treatments before they see an improvement," he said.

"I have spoken to the pharmaceutical company and I am trying to design drugs trials."

Around 150 to 200 women whose cancer has spread and have very few other options could potentially benefit annually.

One of the upsides is that it does not have the side effects of more conventional treatments.

Other patients who have sarcoma - a cancer that affects the tissues that connect, support and surround other body structures and organs - are also seeking wider access.

"Some of the patients I am seeing tend to have very few other options," Dr Fennelly added.

"It is a relatively easy treatment."

The drug has been licensed for use by cervical cancer patients by the FDA in the US, on the basis of phase two drug trials.

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