Changes to bowel cancer treatments available during the coronavirus pandemic
Page updated: Friday 1 May
The National Institute of Care and Health Excellence (NICE) updated their rapid guidance on treating cancer during the coronavirus pandemic, which included new interim treatment regimens that can be used to treat bowel cancer patients. These are either changes to the way drugs are normally given for bowel cancer, or new drugs that are not yet approved by NICE that have been granted temporary permission to be used during the pandemic.
The reasons for these short term changes are to help clinicians to continue to treat bowel cancer patients in a way that:
- Reduces the need for people to attend hospital to receive medication
- Minimise treatment side effects that might make them more likely to be admitted to hospital
- Provide additional treatment options to patients that are less likely to supress their immune system, which leaves people at greater risk of developing infections, such as COVID-19.
The interim treatment changes are for an initial three-month period only, starting on 23 April 2020.
Any changes to treatments must be discussed with you by your clinical team, outlining the risks and benefits of interim treatment.
If you begin one of these interim treatment regimes during the COVID-19 pandemic before the three month period is up, you will be allowed to continue taking this treatment until you and your clinician jointly decide it is time to stop, or to switch to a different treatment.
The guidance recommends that for bowel cancer patients, the following options can be made available (if appropriate for an individual patient)
- Allow intermittent treatment with chemotherapy that contain cetuximab or panitumumab to reduce the need for treatments that reduce the immune system’s ability to work effectively. Patients will be able to start and stop treatment without concern that they won’t be able to access the treatments again after a significant break.
- For people with newly diagnosed metastatic bowel cancer, who are either MSI high and/or have deficient mis-match repair genes, they will now be able to take Nivolumab, instead of chemotherapy.
- Nivolumab is an immunotherapy drug that helps your immune system find and kill cancer cells.
- It is not yet approved by NICE for bowel cancer (it is currently under review) but is approved for other cancers.
- Using Nivolumab rather than chemotherapy will hopefully reduce the number of hospital appointments people need, and reduce the chances of people developing neutropenia, which makes them much more susceptible to infections.