Patients in England, Wales and Northern Ireland with a rare and aggressive type of skin cancer will get routine access to a new treatment option on the NHS after cost regulators waved through Merck and Pfizer's Bavencio.

The National Institute for Health and Care Excellence has published draft guidelines endorsing the drug as option for patients with Merkel cell carcinoma that has spread to other parts of the body who have previously been treated with chemotherapy.

NICE is also recommending Bavencio (avelumab) for use on the Cancer Drugs Fund in England as a first-line treatment for the disease, after concluding that it has the potential to be cost effective in this setting at the confidential discounted price agreed in the patient access scheme, but that more evidence is needed to address the clinical uncertainties.

Patients across Wales will also be able to access the medicine as a first-line option through the New Treatment Fund, which funds all treatments with a positive recommendation from NICE, including those in the CDF with draft recommendations.

Merkel cell carcinoma is an aggressive cancer with limited treatment options, diagnosed in more than 1,500 people between 1999-2008. Seventy-nine percent died within two years of their diagnosis, highlighting the need for new treatment options to improve prognosis for patients with the disease.

Bavencio is a form of immunotherapy and works by harnessing the power of the patient’s own immune system to destroy their cancer cells, approved in September last year as the first and only targeted systemic treatment to be licensed for metastatic MCC.

Data from the Phase II trial JAVELIN Merkel 200 showed durable responses to drug; the proportion of patients who achieved an objective response was 28 (31.8 percent) of 88 patients, including eight complete responses and 20 partial responses.

“It’s fantastic news that NICE can recommend a treatment such as avelumab for patients with metastatic Merkel Cell Carcinoma. Patients with such rare cancers often don’t have access to funded treatments. This is a great outcome for patients and their families,” commented Catherine Bouvier, chief executive of NET Patient Foundation.

It is thought that there are around 50 new cases of mMCC annually in the UK, but data show that the incidence rising, possibly because of an ageing population or increased UV exposure.