PBS listing for immunotherapy drug brings hope to patients with advanced melanoma

Lifesaving drug: Donna Boyle with husband Adam during her immunotherapy treatment.
Lifesaving drug: Donna Boyle with husband Adam during her immunotherapy treatment.

A lifesaving immunotherapy drug that is being used to stop cancer from recurring in some high-risk melanoma patients has just been added to the Pharmaceutical Benefits Scheme (PBS) as an adjuvant treatment.

OPDIVO (nivolumab) has been approved for use in Australia since 2016 and is used to treat a number of advanced cancers including lung, head and neck, kidney, bladder and liver.

From March 1, eligible patients will be able to access the drug as an adjuvant treatment under the PBS. The federal government said it could save patients up to $100,000 per treatment.

Adjuvant treatment is given to people who have a high chance of cancer recurrence. Without it, patients must simply wait and see if their cancer returns.

The federal government said expanding the drug's current PBS listing would bring hope to about 2000 eligible melanoma sufferers.

The breakthrough immunotherapy drug works by blocking proteins and helping the body's own immune system to find, attack and destroy cancer cells. It offers less side effects and a greater chance of recovery compared with other treatments.

A course of treatment currently costs non-eligible patients $100,000 a year.

The government has also expanded the listing of Opdivo and another drug Yervoy (ipilimumab) to allow use as a first-line therapy in the treatment of other types of melanoma.

Second chance: Donna, Adam and Tedd.

Second chance: Donna, Adam and Tedd.

Donna Boyle, of Woolooware, first noticed a small, rough itchy patch of skin on her leg in 2013.

"It was the tiniest, tiniest bit of dry skin," she said.

After her dermatologist tried twice to burn it off, it returned in the form of a blood blister.

She asked to be referred to another skin specialist just before she was due to depart on an overseas holiday in 2014.

"He said 'I am taking it off'. He said afterwards he knew straight away it was melanoma," Donna said.

She was referred to Melanoma Institute Australia and underwent surgery a week later. Doctors removed a 100 centimetre flap of skin, including a "big chunk of my calf", before tests showed she had stage III aggressive melanoma.

In 2017, Donna and husband Adam had just returned from their honeymoon when she found a lump on her leg near where the original melanoma had been removed.

"It was on one of the scars so I was hoping at first it was just scar tissue," she said.

Donna was again diagnosed with melanoma and underwent more surgery.

Then last July another lump appeared. The melanoma had returned. After more surgery, her oncologist recommended adjuvant immunotherapy treatment.

She was given access to OPDIVO for free by manufacturer Bristol-Myers Squibb as part of the Patient Access Program.

Donna, now 46, underwent six months' treatment, which ended in February, and said she had very few side effects.

"They can't say I am cured but they feel that it will not come back," she said.

Donna said the mental toll of dealing with recurrent cancer was immense.

"You live from scan to scan. Every scan is your worst nightmare because you feel something is going to come back," she said.

"I would hate to think what would happen if this was not on the PBS. I would not have been able to afford it."

Associate Professor Matteo Carlino, an oncologist and lead investigator at the Melanoma Institute Australia, welcomed the PBS listing.

"Traditionally, once patients finished their primary treatment, usually surgery, the approach was to watch and wait, hoping the cancer did not return. Now, adjuvant treatment can help reduce the risk of cancer returning for some patients," he said.

Melanoma Patients Australia chief executive Victoria Beedle said the PBS listing would give patients hope and substantially reduce the anxiety and fear around a recurrence.