NHS Scotland will fund pazopanib for adults with certain subtypes of advanced soft tissue sarcoma, following a review supported by evidence from Sarcoma UK and patients.
The decision means that some people who would otherwise receive intravenous chemotherapy in hospital will have the option of taking a tablet at home.
The National Cancer Medicines Advisory Group (NCMAG), part of Healthcare Improvement Scotland, has supported the use of pazopanib for people with selected subtypes of advanced soft tissue sarcoma who:
- have previously received chemotherapy for metastatic disease; or
- experienced cancer progression within 12 months of earlier treatment.
The proposal was submitted by the Scottish Sarcoma Managed Clinical Network, with Sarcoma UK acting as its patient group partner throughout the review.
Reducing the impact of hospital-based treatment
Current treatments for advanced soft tissue sarcoma include ifosfamide and trabectedin. These are given intravenously and can require admission to hospital.
Pazopanib is taken once a day as a tablet. It works by blocking signals that help tumours develop new blood vessels, which can slow or stop tumour growth.
For people with sarcoma in Scotland, the option to take treatment at home could be particularly important. Patients may need to travel considerable distances to attend one of the country’s five specialist sarcoma centres.
Pazopanib will not be suitable for everyone and, like all cancer treatments, can cause side effects. However, it provides another option for eligible patients whose cancer has progressed after previous treatment.
Patient experiences informed the decision
Sarcoma UK’s submission to NCMAG drew on interviews with people who had experience of both pazopanib and standard chemotherapy.
One patient described intravenous treatment as “the toughest thing I’ve ever done”. Another said that the effects of chemotherapy spread “to everything” in their life.
People who had taken pazopanib told us they had been able to continue working and maintain more of their usual daily life during treatment.
Following the announcement yesterday, Dundee resident Shelagh Allison, who lost her husband, Terry, to a soft tissue sarcoma cancer in 2013, said: “Terry went through such a harsh course of chemotherapy in his fight against angiosarcoma, and I know how much that took out of him, physically and emotionally. Patients in Scotland now having the option of a tablet taken at home, rather than what Terry endured, is fantastic news to hear. No family should have to watch someone they love go through what we did without other options being available. Every new treatment that becomes available is a step forward, and I’m so glad this one will be there for patients and families who come after us.”
Richard Davidson, Chief Executive of Sarcoma UK, said:
“This is a very welcome decision for people in Scotland living with advanced soft tissue sarcoma.
“Because sarcoma is rare, patients are too often left behind when it comes to access to new treatments. Having a therapy that can be taken at home can reduce the disruption caused by hospital-based treatment and make a meaningful difference to quality of life.
“We are proud to have supported this proposal with evidence directly from patients and families. We are also grateful to NCMAG and the Scottish Sarcoma Managed Clinical Network for recognising how much this decision matters.
“Pazopanib will not be right for everyone, but for those who can take it, it offers an important alternative to intensive hospital-based chemotherapy. We hope this decision will lead to further progress for people affected by sarcoma and other underserved cancers.”
Improving access to sarcoma treatments
Soft tissue sarcoma is a rare cancer. Around 5,200 people are diagnosed with soft tissue sarcoma across the UK each year.
Treatment options remain limited, particularly when the cancer is advanced or has spread to other parts of the body. Sarcoma UK continues to campaign for people affected by sarcoma to have fair and timely access to effective treatments.
The decision applies to NHS Scotland. It was made through the NCMAG process, which considers cancer medicines proposed by clinicians outside the standard Scottish Medicines Consortium process.
Who is eligible?
The recommendation applies to adults with certain subtypes of advanced soft tissue sarcoma who have previously received chemotherapy for metastatic disease or whose cancer has progressed within 12 months of (neo)adjuvant treatment.
The subtypes included are:
- Adult fibrosarcoma
- Myxofibrosarcoma
- Sclerosing epithelioid fibrosarcoma
- Malignant solitary fibrous tumour
- Pleomorphic malignant fibrous histiocytoma (MFH), giant cell MFH and inflammatory MFH
- Leiomyosarcoma
- Malignant glomus tumours
- Pleomorphic and alveolar rhabdomyosarcoma
- Epithelioid haemangioendothelioma
- Angiosarcoma
- Synovial sarcoma
- Epithelioid sarcoma
- Alveolar soft part sarcoma
- Clear cell sarcoma
- Desmoplastic small round cell tumour
- Extra-renal rhabdoid tumour
- Malignant mesenchymoma
- PEComa
- Intimal sarcoma
- Malignant peripheral nerve sheath tumour
- Undifferentiated soft tissue sarcoma (NOS)
- Other soft tissue sarcoma subtypes not specifically listed as ineligible.
This recommendation does not include: liposarcoma, GIST, chondrosarcoma, osteosarcoma, Ewing sarcoma, dermatofibrosarcoma protuberans (DFSP), inflammatory myofibroblastic tumour (IMT), malignant mesothelioma, mixed mesodermal tumours of the uterus, and most rhabdomyosarcomas.
Please note: Not everyone with soft tissue sarcoma will be eligible. If you have questions about whether this recommendation applies to you, speak to your sarcoma specialist team.
