Olaparib in combination with bevacizumab for ovarian, fallopian tube or primary peritoneal cancer – maintenance therapy
Olaparib belongs to a group of drugs called PARP enzyme inhibitors while bevacizumab is an anti-VEGF monoclonal antibody. Both drugs act in different but synergistic ways to kill tumour cells. It is thought that bevacizumab may increase the sensitivity of olaparib to killing the tumour cells. Olaparib administered orally as a monotherapy is already licensed as a maintenance therapy of advanced ovarian cancer. The addition of bevacizumab given by intravenous infusions may potentially improve treatment outcomes.
131I-omburtamab for neuroblastoma with central nervous system or leptomeningeal metastasis in paediatric patients
131I-omburtamab is a monoclonal antibody that binds to the surface of neuroblastoma cells. It is linked to radioactive iodine (iodine-131) that produces low-level radiation with a short range, a type of treatment known as radioimmunotherapy. As such, 131I-omburtamab delivers precision radiation to the cancer cells. This radiation from the iodine damages the DNA of the cancer cells which shrinks the tumour and therefore controls the disease. 131I-omburtamab is given by injection into cerebrospinal fluid. If licensed, 131I-omburtamab may offer a treatment option for children with neuroblastoma which has spread to the central nervous system or brain.
Nivolumab in combination with cabozantinib for metastatic renal cell carcinoma – first-line
Nivolumab works by improving the activity of white blood cells thereby increasing the ability of the immune system to kill cancer cells. Cabozantinib works to stop signals that cancer cells use to divide and grow. It is thought that when used in combination, both drugs may be more effective than each drug on its own. If licenced, nivolumab in combination with cabozantinib may improve long-term outcomes in mRCC patients who currently have limited treatment options.
Nivolumab in combination with ipilimumab for oesophageal squamous cell carcinoma – first line
Nivolumab and ipilimumab are immune therapy medicinal products that are currently licensed as a combination treatment of advanced cancers such as melanoma and kidney cancer. Nivolumab works by improving the activity of white blood cells (T-cells) thereby increasing the ability of the immune system to kill cancer cells. Ipilimumab works in a different way but also to increase the activity of T-cells. It is thought that when used together, both drugs may be more effective than each on its own. Both drugs given by injection and the combination may offer a treatment option for patients with advanced, recurrent or metastatic oesophageal squamous cell carcinoma who have not been treated previously.
Olaparib for BRCAm or ATM mutated metastatic castration-resistant prostate cancer
Olaparib is taken orally and works by blocking a protein called poly [adenosine diphosphate-ribose] polymerase (PARP). PARP is an important protein which tries to fix damaged deoxyribonucleic acid (DNA). By blocking PARP from fixing damaged DNA, the tumour cells may die. If licensed, olaparib will offer an additional treatment option for men with metastatic castrate-resistant prostate cancer with BRCAm or ATM mutations who have progressed following a prior new hormonal agent.
Durvalumab with or without tremelimumab in addition to platinum based chemotherapy for extensive-stage disease small-cell lung cancer
There are few treatment options available for this condition, and the standard treatment of chemotherapy has not changed for several decades. Durvalumab and tremelimumab are a new kind of treatment for this cancer called immunotherapy that helps the body’s immune system to fight the cancer. These medicinal products are given by intravenous infusion together with chemotherapy. Durvalumab is already licensed in the UK for the treatment of a different type of lung cancer. The combination treatment may be more effective than either treatment alone, and could provide an additional treatment for patients who currently have few effective therapies.
Nivolumab in combination with rucaparib for metastatic castration-resistant prostate cancer with prior chemotherapy
Nivolumab works by improving the activity of a type of white blood cells called T-cells thereby increasing the ability of the immune system to kill cancer cells. Rucaparib also has anti-tumour activity by blocking the effect of certain enzymes leading to the death of tumour cells. It is thought that when used in combination, both drugs may be more effective than each drug on its own. If licenced, nivolumab in combination with rucaparib may improve long-term outcomes in mCRPC patients who currently have limited treatment options.
Histamine dihydrochloride (Ceplene) in combination with low dose interleukin-2 as maintenance treatment for acute myeloid leukaemia
Histamine dihydrochloride is an immunostimulant. This means that it changes the activity of the immune system (the body’s natural defences). Histamine is a substance occurring naturally in the body that is involved in many processes. In the treatment of AML, it is thought to work by protecting immune system cells from damage. This improves the effectiveness of IL-2, a medicine that stimulates the immune system to attack cancerous cells. When histamine dihydrochloride is given with IL-2, it helps the immune system to kill the leukaemia cells that may remain in the body during remission. This may increase the likelihood for patients to remain in long-term remission.
Cediranib in combination with olaparib for recurrent platinum-resistant ovarian cancer – fourth line or greater
Cediranib works by blocking several specific proteins called the vascular endothelial growth factor (VEGF) receptors that are important in the formation of blood vessels to the tumour. Olaparib is a PARP inhibitor which acts by blocking DNA repair leading to the cancer cell death. Olaparib is currently licenced for use in some types of ovarian cancer. Both cediranib and olaparib are taken orally. The combination has demonstrated the potential to act synergistically to improve long-term outcomes in recurrent ovarian cancer patients who currently have limited options beyond third-line treatment.