Nivolumab in combination with cisplatin and fluorouracil for oesophageal cancer – first-line
Nivolumab in combination with cisplatin and fluorouracil is in clinical development for patients with unresectable, advanced, recurrent or metastatic oesophageal squamous cell cancer cell carcinoma. Advanced oesophageal cancer begins in the food pipe and spreads to other parts of the body. Squamous cell cancers develop from the cells that make up the inner lining of the oesophagus. Symptoms include difficulty swallowing, persistent acid indigestion or heartburn, weight loss, pain in the throat, and chronic cough. Lifestyle factors are attributed to most oesophageal cancers, including smoking and being overweight.
Olaparib monotherapy for BRCA-mutated platinum-sensitive relapsed ovarian, fallopian tube or primary peritoneal cancer
Olaparib is a medicinal product currently in development for the treatment of Breast Cancer Gene (BRCA)-mutated relapsed ovarian, fallopian tube or primary peritoneal cancer in patients who have received at least 2 prior platinum treatments and have progressed at least 6 months after their last platinum treatment. Ovarian cancer includes a group of tumours that arise from diverse types of tissue contained in the ovary and can often spread from the ovary to any surface within the abdominal cavity including the fallopian tubes and peritoneal cavity.
Pertuzumab and trastuzumab (fixed-dose combination) in addition to chemotherapy for breast cancer
Pertuzumab/trastuzumab (fixed-dose combination (FDC) in addition to chemotherapy is in clinical development as a subcutaneous formulation (SC) for the adjuvant treatment of adults with the human epidermal growth factor receptor 2 (HER2) positive early and metastatic breast cancer. HER2 positive breast cancer is a subtype in which the HER2 receptor is over expressed on the cell surface. HER2 promotes the growth of cancer cells and this breast cancer subtype tends to be more aggressive than other types. Metastatic breast cancer is when cancer has spread beyond the breast and nearby lymph nodes to other organs in the body. Treatment of the disease often involves the use of anti-HER2 therapies, chemotherapy or a combination of both.
Durvalumab in combination with tremelimumab for unresectable hepatocellular carcinoma – first line
Durvalumab in combination with tremelimumab is in clinical development for patients with unresectable hepatocellular carcinoma (HCC), the most common type of liver cancer that occurs mainly in patients with underlying chronic liver disease and cirrhosis. Unresectable HCC occurs when the cancer has spread to lymph nodes or to other organs and cannot be treated by surgery. Unresectable HCC is often diagnosed late in life and has a poor prognosis. It is a debilitating condition with many distressing symptoms, including pain, digestive problems and weight loss. The current standard of care can only slow the progression of the cancer and extend survival.
Trastuzumab emtansine in combination with pertuzumab for HER2-positive early breast cancer – adjuvant therapy
Trastuzumab emtansine consists of an anti-HER2 therapy (trastuzumab) and a chemotherapy agent (emtansine or DM1) combined together as an antibody-drug conjugate. Trastuzumab specifically binds to cancer cells that are HER2-positive which provides a targeted delivery of the cytotoxic DM1 inside cancer cells, potentially limiting damage to healthy tissue. Pertuzumab, is designed to attach to HER2, and stop HER2 producing signals that cause the cancer cells to grow. The combination is thought to provide a more comprehensive, dual blockade of HER pathways and prevent tumour cell growth and survival, and if licenced, will offer an additional adjuvant treatment option for patients with HER2- positive early breast cancer.
Nivolumab for platinum-resistant advanced or recurrent ovarian cancer
Nivolumab is in development for the treatment of platinum-resistant, advanced or recurrent ovarian cancer. Ovarian cancer is one of the most common types of cancer in women. The symptoms of the disease are vague, including loss of appetite and tummy pain. This can mean that the cancer is often diagnosed when the disease is advanced and more difficult to treat. Most patients have the cancer removed by surgery and also receive chemotherapy, which usually includes platinum-based drugs. However, ovarian cancer often recurs and the platinum-based chemotherapy drugs may be less effective at treating this recurrence. If the cancer recurs within 6 months of the previous treatment, and platinum-based chemotherapy does not work, the disease is called ‘platinum resistant’.
Carfilzomib in addition to daratumumab and dexamethasone for relapsed and/or refractory multiple myeloma
Carfilzomib, is a proteasome inhibitor. Proteasome is a system within the cells that breaks down proteins that are no longer needed. Cancer cells have an increased need to produce and break down proteins as they multiply rapidly. When carfilzomib stops the proteasome from breaking down proteins in the cancer cells, the proteins build up and cause the cells to die, slowing down the growth of the cancer. The addition of daratumumab and dexamethansone to carfilzomib may potentially improve outcomes and reduce side effects in patients with relapsed and/or refractory MM who have received prior therapies.
Atezolizumab in addition to paclitaxel for inoperable, locally advanced or metastatic triple negative breast cancer – first-line
Atezolizumab as an intravenous infusion in combination with an intravenous infusion of paclitaxel (chemotherapy) is in clinical development for the first-line treatment of locally advanced or metastatic triple-negative breast cancer (TNBC). TNBC is a type of breast cancer in which the cancer cells do not express receptors for oestrogen or progesterone or HER2 protein. Treatment of TNBC is challenging because of a lack of targeted therapy, aggressive disease course, and relatively poor prognosis. Treatment is usually through a combination of surgery, radiotherapy, and chemotherapy.
Ixazomib citrate for newly diagnosed multiple myeloma inelgible for autologous stem cell transplant– maintenance therapy
Ixazomib citrate is a novel oral medicinal product that is already licensed in the UK for the treatment of MM in patients who have received at least one prior therapy (in combination with lenalidomide and dexamethasone). Ixazomib citrate offers the potential advantage over similar medicines in its class of being more effective in its anticancer activity, reduced side effects and more convenient to administer (through its weekly oral dosing). If approved as maintenance therapy for NDMM patients, ixazomib maintenance has the potential to prolong the time patients live without their disease getting worse (progression free survival) as well as offering more convenient oral dosing that allows long term administration and improvement of patients’ quality of life.
Ibrutinib in addition to rituximab for chronic lymphocytic leukaemia – first-line
Ibrutinib works against cancerous B lymphocytes, which are a type of white blood cells affected by these diseases. It does this by blocking an enzyme called Bruton’s tyrosine kinase (BTK), which promotes survival of B lymphocytes and their migration to the organs where these cells normally divide. By blocking BTK, ibrutinib decreases the survival and migration of B lymphocytes, thereby delaying the progression of cancer. Ibrutinib is available in tablets taken orally. If licensed, ibrutinib in addition to rituximab will offer an additional first-line treatment option for untreated young and fit patients with CLL or SLL.