Last month, our charity lodged a supporting submission to PHARMAC, requesting the funding of the life saving drug, KEYTRUDA, for adult and paediatric patients across New Zealand.

PHARMAC is the New Zealand government agency that decides which medicines and related products are funded in New Zealand.

Bowel Cancer Foundation Trust requested that KEYTRUDA be used as first line treatment of all patients who have microsatellite instability-high (MSI-H) in colorectal cancer as well as other disease types with a prevalence of the MSI-H gene mutation, including but not limited to gastric, rectal, breast and endometrial adenocarcinomas.

Results from the maker of KEYTRUDA, Merck Sharp and Dohme’s phase 3 KEYNOTE-177 trial data released at the end of May 2020, proves KEYTRUDA doubles the progression free survival time of cancer patients with the MSI-H gene mutation when compared to the current standard first line treatment of chemotherapy.

As part of an interim analysis of clinical trial data, presented at the American Society of Clinical Oncology (ASCO) Annual Meeting, results also showed 11% of patients who were treated with KEYTRUDA were found to have a 'complete response' where their disease had disappeared from scans.

Furthermore, in almost half the patients who had KEYTRUDA (48.3%), their disease had not progressed after two years versus only a fifth of patients who had had chemotherapy (18.6%), which means the beneficial effects are also durable.

KEYTRUDA has shown to work as a front line treatment for 39 different cancer types with a prevalence of the MSI-H gene mutation. In New Zealand that equates to approx. 244 cancer patients a year.

We calculated the number of New Zealander cancer patients across all 39 cancer types who are likely to be diagnosed each year with the MSI-H gene mutation to determine how many people would benefit from KEYTRUDA when funded by PHARMAC.

Only 27 of these cancers had recordable findings in New Zealand.

We compared the data for the 27 cancers against the The NZ Cancer Registry 2017 and found 12 cancer types registered in New Zealand had recordable data relevant to our country.

With this information we could estimate the total number of New Zealanders with the MSI-H gene mutation who would benefit from KEYTRUDA each year to be 244.

Cancer Type

Deaths

Metastatic MSI-H Prevalence

Patient Numbers

Colorectal

1300

4%

52

Uterus/Endometrial

174

17%

30

Ovarian

213

11%

23

Pancreas

554

4%

22

Prostate

691

4%

28

Kidney

232

4%

9

Breast

689

1.7%

12

Cervical

48

9%

4

Esophageal

249

10%

25

Bilary Tract

45

7.5%

3

Small Intestine

94

7%

7

Stomach

234

12.5%

29

TOTAL

244

The cost of cancer for these 244 patients in New Zealand is not just calculated in terms of treatment but the loss of family income, of family experiences and memories as well as the emotional cost cancer brings, must also be included.

We believe the lives of cancer patients should not be reduced to a number or their worth determined by a dollar figure.

The Ministry of Health tells us they are committed to ensuring we have a sustainable system that enables New Zealanders to have fewer cancers, better survival rates and equitable outcomes and have created a New Zealand Cancer Action Plan covering the next ten years.

The recent Hon David Clark, Minister of Health states in the New Zealand Cancer Action Plan 2019-2029 that New Zealand is on a path to better cancer prevention, treatment and care.

KEYTRUDA has already been proven to provide a better path to improve cancer outcomes for patients with the MSI-H gene mutation and reduce the number of New Zealanders dying prematurely from all cancer types.

There are a number of successful stories of MSI-H (Lynch Syndrome patients) who have undergone KEYTRUDA treatment and are still here to share their stories today, as well as the tragedy of other patients who are not.

We would like to thank the volunteers who donated their time to complete this submission as well as the bravery of the patients who have shared their stories with us over the years.

Like 52 year old Christchurch dad of 2, Jack Davis, who was forced to undergo bullying and social media trolling when begging for financial help to pay for KEYTRUDA to stay alive.

Like 65 year old Sally Rangimare Wast who has painfully reached the decision to stop KEYTRUDA treatment because of the burden of cost on her family to continue. The KEYTRUDA treatment has already proven successful to reduce her tumours and gave her 18+ months of remission.

Like 31 year old Whitinga Harris who tragically passed away before he had time to finish fundraising to pay for the unfunded cost of KEYTUDA before he could start treatment.

These 3 bowel cancer sufferers are just a snap shot of the patients we hear from at Bowel Cancer Foundation Trust, and can see the familiarity in their stories that are constantly presented to us.

PHARMAC's decision to fund KEYTRUDA, to be used as first line treatment of all patients who have microsatellite instability-high (MSI-H), will ensure we never have to hear them again.

Bowel Cancer Foundation Trust will continue to fight for all bowel cancer patients throughout New Zealand to receive equity of care across the country.

To learn more about our KEYTRUDA cost share programme, click here