Beating bowel cancer together

New drug which could extend life expectancy of some advanced bowel cancer patients approved in Scotland

Monday 13 December 2021

A new drug combination which may extend life expectancy for some people with advanced bowel cancer, has been approved by the Scottish Medicines Consortium (SMC) for patients in Scotland.

Bowel cancer is the fourth most common cancer in Scotland with around 4,200 people diagnosed every year.  

Nivolumab, in combination with ipilimumab, will now be available on the NHS for people in Scotland with specific genetic changes known as ‘high microsatellite instability or mismatch repair deficiency’. This combination is available for patients who have already had combined chemotherapy.

People with advanced bowel cancer - where the disease has spread to other parts of the body – are normally treated with chemotherapy, sometimes in combination with other treatments. But around 5% of advanced bowel cancer patients have changes to their mismatch repair genes, which can result in cancers with high microsatellite instability (MSI-H) or mismatch repair deficiency (dMMR). This also includes some people with Lynch syndrome. This makes them less likely to respond well to current treatments, often leading to poorer outcomes.

Dr Lisa Wilde, Director of Research and External Affairs at Bowel Cancer UK, says: "This decision by the SMC will bring new hope for this small, but sadly overlooked group of advanced bowel cancer patients in Scotland who, until now, have faced very limited treatment options. Nivolumab, in combination with ipilimumab, may give patients more valuable time with their loved ones, as well as a better quality of life and less severe side effects.

"We submitted evidence to SMC to highlight the impact of living with stage 4 bowel cancer and the potential benefits of immunotherapy, and we’re really pleased that this was considered in the decision-making.”

Dr Janet Graham, Consultant Oncologist at the Beatson West of Scotland, said: “Until now, clinicians had very limited treatment options to offer patients with this rare form of advanced bowel cancer, when chemotherapy fails. The acceptance of this combination of nivolumab and ipilimumab is an advance for these patients with this rare form of advanced bowel cancer and will allow us to offer our patients a new treatment option to potentially combat this devastating disease.”

The National Institute for Health and Care Excellence (NICE) also approved Nivolumab, in combination with ipilimumab, for advanced bowel cancer patients in England and Wales in June 2021.

  • Read more about advanced bowel cancer including treatment, wellbeing and real life stories

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