Lord Avebury MP (NONE) To ask Her Majesty’s Government which drugs have
been delisted from the Cancer Drugs Fund; how many patients are currently
being treated with each drug; and what steps they are taking to develop a new
system for prescribing each drug. HL3340
NHS England publishes information on the number of patient applications for particular
drugs/indications contained on the national CDF list on a quarterly basis. This information
also includes the number of applications approved through the individual CDF request
process. The latest information is set out in Tables 1-3. It is also available at:
www.england.nhs.uk/ourwork/pe/cdf/.
Table 1: Notifications - patient numbers and invoiced spend
Drug
Abiraterone
Albumin bound
paclitaxel
Axitinib
Bendamustine
CDF indication
1st line treatment of metastatic
castrate resistant prostate cancer
(Mcrpc) in adult men who are
symptomatic, or mildly
symptomatic, after failure of
androgen deprivation therapy
(ADT) in whom chemotherapy is
not yet clinically indicated
The first line treatment of
advanced adenocarcinoma of the
pancreas in combination with
gemcitabine
Option for 2nd line advanced
renal cell carcinoma with
progression after TKI or a
cytokine (until 27th May 2015)
2nd or subsequent line treatment
of CLL for patients whom
fludarabine combination therapy
is not a therapeutic option
Treatment of relapsed low grade
NHL in patients unable to receive
standard chemotherapy
1st line treatment of low grade
non-hodgkins lymphoma in
combination with rituximab
2nd and subsequent line
treatment of mantle cell
lymphoma in patients who have
not received previous
bendamustine
1st line treatment of mantle cell
lymphoma in combination with
rituximab in patients unsuitable
for standard first line treatment
Treatment of relapsed multiple
myeloma where other treatments
are not appropriate
Total
number of
application
received for
each
indication
Apr-15
Total
number of
application
received for
each
indication
May-15
Total
number of
application
received for
each
indication
Jun-15
Total
number of
application
received for
each drug
80
70
86
236
41
40
46
127
34
36
34
104
9
20
20
25
47
33
57
46
83
438
4
3
3
10
5
11
17
27
18
Bevacizumab
Treatment of patients with triple
negative metastatic breast cancer
and/or prior taxane therapy
11
16
18
1st line treatment recurrent or
metastatic cervical cancer
16
19
25
36
33
48
2nd line treatment of metastatic
colorectal cancer in combination
with standard chemotherapy in
patients who have not previously
received bevacizumab. Only to be
administered concurrently with
chemotherapy, not as single
agent maintenance therapy.
3rd line treatment of metastatic
colorectal cancer in combination
with standard chemotherapy in
patients who have not previously
received bevacizumab. Only to be
administered concurrently with
chemotherapy, not as single
agent maintenance therapy
The third line treatment of low
grade gliomas of childhood
Bortezomib
1st line treatment of advanced
(stage IIIc/IV) ovarian cancer,
suboptimally debulked either at
primary or delayed primary
(interval) surgery (including
peritoneal and fallopian tube
cancer) OR unsuitable for
debulking surgery
Treatment of relapsed or
refractory multiple myeloma at
second and subsequent relapse in
patients who are bortezomib
naïve and where the patient
unable to access bortezomib at
first relapse
Treatment of chronic phase CML
refractory to nilotinib or dasatinib
Bosutinib
Brentuximab
Treatment of accelerated phase
CML refractory to nilotinib or
dasatinib
Treatment of chronic phase CML
where there is significant
intolerance to dasatinib and
nilotinib
Treatment of accelerated phase
CML where there is significant
intolerance to dasatinib and
nilotinib
Treatment of relapsed or
refractory Hodgkins lymphoma in
patients who have failed at least
two prior multi-agent
chemotherapy regimens and are
not ASCT candidates
Treatment of relapsed/ refractory
anaplastic large cell lymphoma
where no other salvage treatment
is available (from 12/01/2015)
432
9
4
11
1
0
2
56
64
63
11
8
10
6
3
6
0
0
0
3
5
1
0
0
0
14
25
13
29
24
62
5
1
4
Cabazitaxel
Cabozantinib
Cetuximab
Clofarabine
Crizotinib
Dasatinib
Treatment of castrate-resistant
metastatic prostate cancer in
patients who have had previous
treatment with docetaxel based
regimens (from 22/05/2015)
Treatment of progressive,
unresectable locally advanced or
metastatic medullary thyroid
carcinoma
1st line treatment of metastatic
and/or recurrent squamous cell
carcinoma of the head and neck
1st Line treatment of metastatic
coloreactal cancer in combination
with the following regimens:
FOLFOX4 or FOLFOX6 or OxMdG
Chemotherapy (From
13/02/2014)
1st line treatment of metastatic
colorectal cancer in combination
with Irinotecan based
chemotherapy (From 13/02/2014)
3rd and subsequent line
treatment of metastatic colorecal
cancer as a single agent (From
13/02/2014)
3rd and subsequent line
treatment of metastatic colorecal
cancer as a single agent in
patients not treated to
progression under NICE TA176
(From 13/02/2014)
Acute myeloblastic leukaemia in
patients with relapsed/refractory
disease in whom the intent is to
use treatment as a bridge to bone
marrow transplantation
Acute lymphoblastic leukaemia in
patients with relapsed/refractory
disease in whom the intent is to
use treatment as a bridge to bone
marrow transplantation
In second and subsequent line
anaplastic lymphoma kinase
(ALK)-positive advanced nonsmall lung cancer
Treatment of adults with
Philadelphia chromosome positive
(Ph+) acute lymphoblastic
leukaemia (ALL) with resistance
or intolerance to prior therapy
including Imatinib (from
12/01/2015).
Treatment of chronic phase CML
which is refractory or significant
intolerance to imatinib and
intolerance to nilotinib
Treatment of accelerated phase
CML which is refractory or
significant intolerance to imatinib
and intolerance to nilotinib
0
4
41
45
1
0
0
1
23
18
20
4
6
10
69
79
104
29
34
37
9
3
5
3
4
5
450
16
2
0
2
8
14
12
2
1
5
34
29
9
5
7
0
0
0
Enzalutamide
Eribulin
Everolimus
Ibrutinib
Idelalisib
Lenalidomide
Nelarabine
The treatment of chemotherapy
naïve castrate-resistant Metastatic
Prostate Cancer
Treatment of patients with locally
advanced or metastatic breast
cancer who have been previously
treated with (or unsuitable for) an
anthracycline, a taxane and
capecitabine
2nd line treatment of metastatic
renal cell carcinoma where
disease has progressed on or
after treatment with VEGFtargeted therapy or where patient
has a contra-indication to or is
intolerant of VEGF targeted
therapy
1st or 2nd line treatment of
unresectable or metastatic,
moderately differentiated
neuroendocrine tumours of
pancreatic origin in adults with
progressive disease (from
12/01/2105)
2nd line treatment of hormone
receptor +ve, HER2 negative
advanced breast cancer, in
combination with exemestane, in
post menopausal women without
symptomatic visceral disease
after recurrence or progression
following a non steroidal
aromatase inhibitor who have not
received previous exemestane
234
204
223
661
55
68
112
235
14
11
15
4
3
2
175
35
39
52
Treatment of relapsed/ refactory
chronic lymphocytic leukaemia
56
55
65
Treatment of relapsed/ refractory
mantle cell lymphoma
26
18
23
10
14
19
23
19
20
In combination with rituximab for
the treatment of adult patients
with relapsed chronic lymphocytic
leukaemia (CLL) not eligible for
cytotoxic therapies
2nd line treatment of multiple
myeloma in patients who have
contraindications to the use of
bortezomib
Transfusion-dependent anaemia
due to low- or intermediate-1-risk
myelodysplastic syndromes
associated with an isolated
deletion 5q plus one other
cytogenetic abnormality when
other therapeutic options are
insufficient or inadequate (from
19/01/2015)
Treatment of refractory T-cell
lymphoblastic non-Hodgkin’s
lymphoma as a bridge to bone
marrow transplantation
243
43
65
1
0
2
0
2
0
6
Ofatumumab
Panitumumab
Pegylated
Liposomal
Doxorubicin
Treatment of refractory T cell
acute lymphoblastic leukaemia as
a bridge to bone marrow
transplantation
In combination with chlorambucil
for the treatment of patients with
CLL who have not received prior
therapy and who are not eligible
for fludarabine-based therapy
(removed 08/09/2015)
1st Line treatment of metastatic
coloreactal cancer in combination
with the following regimens:
FOLFOX4 or FOLFOX6 or OxMdG
Chemotherapy
1st Line treatment of metastatic
coloreactal cancer in combination
with irinotecan based
chemotherapy (from 04/09/2015)
3rd and subsequent line
treatment of metastatic colorecal
cancer as a single agent
3rd and subsequent line
treatment of metastatic colorecal
cancer as a single agent in
patients not treated to
progression under NICE TA176
1st line treatment of sarcoma in
patients with cardiac impairment
who need an anthracycline
2nd line treatment of sarcoma in
patients with cardiac impairment
who need an anthracycline
2nd line treatment of fibromatosis
Pemetrexed
2nd line treatment of patients
with locally advanced or
metastatic nonsmall cell lung
cancer other than predominantly
squamous cell histology in
patients who did not receive 1st
line pemetrexed e.g. 1st line
clinical trial (removed
21/07/2015)
Maintenance treatment of stage
IIIB/IV non-squamous non-small
cell lung cancer after response to
pemetrexed-containing first line
therapy
0
1
3
7
2
3
6
6
6
0
0
0
12
51
6
5
12
2
5
3
1
0
0
2
2
1
0
0
0
10
3
13
6
144
26
33
59
Peptide receptor
Radionuclide
Therapy to
include
Lutetium177
Octreotate or
Yttrium90
octreotide/
octreotate
Treatment of advanced
neuroendocrine tumours, i.e. for
pNETS after
sunitinib/Chemotherapy, For midgut Carcinoid, after
octreotide/somatostatin therapies
20
11
11
42
Pertuzumab
In combination with docetaxel
and trastuzumab for the first line
treatment of locally advanced or
metastatic HER2+ breast cancer
78
69
68
215
Pomalidomide
Ponatinib
Radium-223
Dichloride
Regorafenib
Ruxolitinib
Sorafenib
Sunitinib
Treatment of relapsed and
refractory multiple myeloma who
have received at least two prior
treatment regimens, including
both lenalidomide and
bortezomib, and have
demonstrated disease progression
on the last therapy
Philadelphia-chromosome-positive
acute lymphoblastic leukaemia
(Ph+ ALL) with the T315I
mutation
Chronic Myeloid Leukaemia with
T315I Mutation
Treatment of castration-resistant
prostate cancer patients with
bone metastases
Treatment of adult patients with
advanced (metastatic or
unresectable) gastro-intestinal
stromal tumours (GIST) after
failure of at least previous
imatinib and sunitinib
1st line treatment of symptomatic
splenomegaly in adult patients
with primary myelofibrosis, post
polycythaemia vera myelofibrosis
or post essential
thrombocythaemia myelofibrosis.
For new patients only.
2nd line treatment of
symptomatic splenomegaly in
adult patients with primary
myelofibrosis, post polycythaemia
vera myelofibrosis or post
essential thrombocythaemia
myelofibrosis. For new patients
only.
1st line treatment of advanced
hepatocellular carcinoma in
patients with Childs A disease
1st line treatment of advanced
hepatocellular carcinoma in
patients with low disease burden
Childs B disease
Treatment of papillary or follicular
thyroid cancer that is inoperable
or metastatic disease that’s is
refractory to radioiodine
1st line treatment of unresectable
or metastatic, well-differentiated
pancreatic neuroendocrine
tumour with disease progression
2nd line treatment of
unresectable or metastatic, welldifferentiated pancreatic
neuroendocrine tumour with
disease progression
3rd line treatment of unresectable
or metastatic, well-differentiated
pancreatic neuroendocrine
tumour with disease progression
63
57
72
0
1
0
192
9
0
3
5
64
61
84
209
2
4
6
12
18
22
22
99
18
11
8
35
31
45
10
2
8
1
2
6
2
1
0
4
0
1
2
1
0
140
11
1st line treatment of patients with
advanced renal cell carcinoma
(RCC) who have at least three of
six prognostic risk factors
Treatment of HER2-positive
locally advanced/unresectable or
metastatic (Stage IV) breast
cancer who previously received
trastuzumab and a taxane,
separately or in combination
Treatment of symptomatic, locally
advanced (unresectable) or
metastatic medullary thyroid
cancer.
Symptomatic metastatic basal cell
carcinoma (BCC), or locally
advanced BCC inappropriate for
surgery or radiotherapy
Total
Temsirolimus
Trastuzumab
Emtansine
Vandetinib
Vismodegib
3
2
2
7
46
46
52
144
6
2
4
12
9
3
9
21
1503
1459
1819
4781
Source: NHS England: Quarterly figures – including notifications and Individual Cancer Drug Fund Requests (ICDFRs)
Table 2: Molecular diagnostic tests - patient numbers and invoiced spend
To define eligibility for treatment
with Cetuximab or Panitumumab
in the treatment of colorectal
cancer
Total
RAS Testing
388
251
422
1061
388
251
422
1061
Source: NHS England: Quarterly figures – including notifications and Individual Cancer Drug Fund Requests (ICDFRs)
Table 3: Individual Cancer Drug Fund Requests (ICDFRs) - Region and NHS England by month
Region
London
Midlands
North
South
Month
Number of
applications
received for
consideration
by screening
panel
Number of
applications
put forward for
consideration
by CDF panel
Number of
applications
approved by
CDF panel
Number of CDF
panel decisions
communicated
back to
requester within
10 working days
Number of
applications
refused by
CDF panel
Apr-15
4
1
0
1
1
May-15
12
5
3
2
5
Jun-15
6
1
0
1
1
TOTAL
22
7
3
4
7
Apr-15
7
2
0
2
2
May-15
14
4
0
4
4
Jun-15
16
5
3
2
5
TOTAL
37
11
3
8
11
Apr-15
6
5
2
3
5
May-15
5
3
2
1
3
Jun-15
8
4
2
2
4
TOTAL
19
12
6
6
12
Apr-15
7
2
2
0
2
May-15
9
1
1
0
1
Jun-15
10
1
1
0
1
TOTAL
26
4
4
0
4
NHSE
TOTAL
104
34
16
18
34
Source: NHS England: Quarterly figures – including notifications and Individual Cancer Drug Fund Requests (ICDFRs)