The NHS will offer a new immunotherapy drug to more than 1,500 stomach cancer patients each year in England, following approval by the National Institute for Health and Care Excellence. Durvalumab, sold under the brand name Imfinzi, is the first immunotherapy to be approved for this group of patients and will be available immediately under NHS treatment pathways.

Stomach cancer is among the harder cancers to treat successfully. Gastric and gastro-oesophageal junction cancers, which develop in the stomach or at the point where it meets the oesophagus, are frequently diagnosed at an advanced stage. Even where surgery is possible, recurrence is common. Survival rates are low, with only about half of patients living five years after diagnosis. Clinicians have frequently pointed out the lack of treatment options, especially for those whose disease returns following surgery.

Durvalumab works by blocking the PD-L1 protein, which cancer cells use to avoid detection by the immune system. When this protein is inhibited, the immune system can identify and attack the cancer more effectively. The drug is administered as an intravenous infusion every four weeks and is used alongside FLOT chemotherapy, a standard regimen for operable stomach cancer. Patients receive the combination before surgery to reduce tumour size and continue with durvalumab afterwards to lower the risk of the cancer returning.

Trial data submitted to NICE showed meaningful improvements over chemotherapy alone. Patients receiving durvalumab had a median time to disease progression of just over 40 months, compared with just over 32 months for those on chemotherapy without the immunotherapy. The three-year survival rate was 68.6% in the durvalumab group, against 61.9% in the control group. These figures were sufficient for NICE to conclude the treatment offered a clinically significant benefit.

The drug is approved for adults whose cancer has not spread extensively and who are medically suitable for surgery. Patients outside these criteria are not currently covered by the guidance.

NICE used an expedited appraisal process to reach its decision, bypassing the need for a full committee meeting. This route is applied where clinical evidence is strong and the potential patient benefit is considered high. The effect is that patients can access the treatment sooner than would typically be possible under standard evaluation timelines, which can take considerably longer. The approach reflects a stated aim within the health service to reduce the gap between a drug's approval and its availability to patients.

Sheena Dewan, Executive Director at Stomach Cancer UK, said the approval was the most significant advance in curative treatment for the disease in nearly a decade. "Adding immunotherapy to perioperative chemotherapy offers a real opportunity for lower recurrence and longer survival," she said. "For too long, patients have been enduring the dual burden of life-altering surgery and high rates of recurrence. This treatment gives individuals and families living with the constant fear that the cancer will return a meaningful opportunity for more time with loved ones, more time at work and more time to live well beyond treatment."

The approval places stomach cancer treatment more firmly within the broader shift across oncology towards drugs that work with the immune system rather than relying solely on chemotherapy. For a cancer that has seen relatively little progress in systemic treatment options over the past decade, the introduction of durvalumab gives clinicians a more effective tool at the point of care where intervention has the greatest potential impact, before and immediately after surgery. Whether the approval prompts further investment in immunotherapy research for gastrointestinal cancers more widely remains to be seen, but for the patients who are eligible now, the clinical gains are concrete and measurable.

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