AstraZeneca and Daiichi Sankyo have announced that the Scottish Medicines Consortium (SMC) has accepted Enhertu for restricted use within NHS Scotland.

The therapy – also known as trastuzumab deruxtecan – will be incorporated as a monotherapy for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer who have also received one prior anti-HER2-based regimen.

The decision will create the opportunity for trastuzumab deruxtecan to be used earlier in the treatment pathway and as another option for patients living with metastatic HER2-positive breast cancer.

Other advice from SMC regarding the use of trastuzumab deruxtecan as monotherapy for the treatment of adult patients with unresectable or metastatic HER2-positive breast cancer, who have received two or more prior anti-HER2-based regimens, remains in place.

Haran Maheson, vice president, head of oncology at Daiichi Sankyo UK, was optimistic about the difference that therapy would make: “We are pleased to have worked in partnership with the SMC, NHS Scotland and the breast cancer community to make trastuzumab deruxtecan available earlier in the treatment pathway for eligible patients in Scotland and will work hard to support clinicians in their efforts to improve the quality of care to patients.”

Tom Keith-Roach, president, AstraZeneca UK, commented: “We are delighted with this decision by the SMC. Scotland is currently developing a new cancer strategy, and we look forward to partnering with the Scottish government to set a new ambition for cancer. Part of that ambition must be for rapid access to innovate cancer treatments, empowering the SMC to continue making positive decisions for Scottish patients like the one we’ve seen today.”

The impact of breast cancer is significant across Scotland, with 4,297 new cases diagnosed among women in 2020 alone. Indeed, it remains the most frequently diagnosed cancer in women, with one in eight Scottish women developing it in their lifetime.

The Institute of Cancer Research (ICR) has welcomed the ‘life-changing’ decision by the National Institute for Health and Care Excellence to recommend AstraZeneca’s olaparib. The targeted therapy has been developed for use among NHS patients with both prostate cancer and early-stage breast cancer.

The decision concerns treatment availability for forms of breast and prostate cancer caused by faulty BRCA1 or BRCA2 genes, offering the chance of longer, healthier lives for thousands of patients.

Access to olaparib for these specific groups of patients will follow standard treatment, ultimately helping prevent cancers from returning and improving overall chances of survival.

Meanwhile, men in England and Wales with advanced, incurable prostate cancer, who have BRCA1/2 mutations in their tumours – and whose cancer has progressed in spite of hormone therapy – will also have access to the treatment. Critically, this access has the potential to delay progression of disease, maintaining life for longer.

The ICR experts were grateful to NHS England and manufacturer AstraZeneca for establishing an agreement following complex negotiations over how olaparib would be priced according to different groups of cancer patients.

Professor Andrew Tutt, professor of breast oncology at the ICR, reflected: “This is an amazing moment in a long scientific journey starting with the discovery of the BRCA1 and BRCA2 genes more than 25 years ago, to ICR scientists identifying how to target a weakness in these cancers ten years later, all the way through to the completion of the phase 3 clinical trials.”

He added: “It is immensely satisfying to know this work will now allow patients within the NHS to join the many thousands of patients globally whose lives are transformed by this work.”