Hundreds of women in England with locally advanced cervical cancer will gain access to the immunotherapy drug pembrolizumab on the NHS from today, after the National Institute for Health and Care Excellence approved its use and NHS England agreed a commercial deal with manufacturer MSD. Patients will receive fast-tracked access through the Cancer Drugs Fund.

Pembrolizumab works by blocking the PD-1 protein, which ordinarily suppresses the body's immune responses. By inhibiting this protein, the drug allows immune cells to identify and attack cancer cells more effectively. It is given every three or six weeks, either by infusion or through a recently introduced injectable form that takes around one minute to administer.

The approval applies to women with stages 3 or 4 locally advanced cervical cancer, meaning the disease has spread beyond the cervix to surrounding structures such as the pelvic wall, but has not reached more distant parts of the body. NHS England estimates around 270 patients per year in England will be eligible, with roughly 550 expected to benefit over the next two years.

Evidence for the approval comes from the global KEYNOTE-A18 trial, in which two NHS trusts participated: Royal Devon and Exeter NHS Foundation Trust and The Royal Marsden NHS Foundation Trust. The trial examined outcomes when pembrolizumab was added to standard chemoradiotherapy. At the two-year mark, 68% of patients in the combination group remained free of cancer progression, against 57% of those receiving chemoradiotherapy alone. By three years, 82.6% of patients treated with pembrolizumab and chemoradiotherapy were still alive, compared with 74.8% in the standard treatment group.

Louise Broadbelt, 55, from Surrey, was diagnosed with stage 3 locally advanced cervical cancer when she was 50 and joined the pembrolizumab trial at The Royal Marsden. "Nothing can prepare you for being diagnosed with cancer," she stated. "All you want to hear is you will get the best possible treatment and have hope. I'm very grateful that I was offered the chance to go on the pembrolizumab clinical trial in 2021."

Professor Peter Johnson, NHS National Clinical Director for Cancer, said the approval represented one of the most significant advances in treatment for this form of the disease in recent years. "Combining this immunotherapy with existing treatment has had very positive effect for patients in trials, helping the body's immune system to target cancer more effectively," he said. "We're delighted it will be available for patients on the NHS as it could help hundreds more women survive and stay cancer-free in the long-term."

Sharon Hodgson, the Public Health Minister, described the decision as a meaningful step forward. "Making pembrolizumab available on the NHS will give more patients access to a treatment that could help them live longer and, for some, achieve cancer-free lives," she said. "Women in England will be among the first to benefit, ensuring the latest advances in cancer care reach those who need them most, as quickly as possible."

Cervical cancer is diagnosed in around 3,300 people in the UK each year, making it the 14th most common cancer among women. The pembrolizumab approval follows a series of developments in the treatment and prevention of the disease. Cemiplimab has recently been approved for patients with recurrent or metastatic cervical cancer following chemotherapy. Separately, research has shown that children vaccinated against HPV at age 12 or 13 have close to zero risk of dying from cervical cancer before the age of 30, underlining the continued importance of the national vaccination programme alongside advances in treatment.