Starting July 1, 10 new cancer treatments will be covered by insurance. What will change for patients?

Among the 25 new therapies, 10 are intended for cancer patients. These include modern treatments for lung cancer, colorectal cancer, hepatocellular carcinoma, endometrial cancer, prostate cancer, multiple myeloma, and nasopharyngeal cancer. This is the third update this year to the reimbursement list prepared by the Ministry of Health. The new decisions cover immunotherapies, perioperative and consolidation treatments, as well as molecularly targeted therapies. This means greater opportunities to tailor treatment based on the type of cancer, its stage, and the results of molecular testing.

Lung cancer has the highest number of new treatments

Most of the changes concern lung cancer treatment. Four new treatment options have been added to the list of reimbursed therapies. The first of these is nivolumab, used for perioperative treatment of adult patients with stage II–IIIB non-small cell lung cancer and PD-L1 expression of at least 1 percent. – Perioperative treatment refers to therapy administered both before and after surgery and requires close collaboration between an oncologist and a thoracic surgeon. Results from the CheckMate77T registry study indicate that this approach significantly reduces the risk of disease recurrence as well as the risk of lung cancer-related death – explains Magdalena Knetki-Wróblewska, M.D., Ph.D., from the Department of Lung and Thoracic Oncology.

Starting in July, durvalumab will also be reimbursed for perioperative treatment. The new indications will allow patients without PD-L1 expression to be eligible as well. “These reimbursement indications will also allow for the inclusion of patients in whom no PD-L1 expression has been detected on tumor cells. It is estimated that this applies to as many as 40% of patients,” says Dr. Knetki-Wróblewska.

Another change is the reimbursement of durvalumab as a consolidation therapy for patients with small-cell lung cancer following completion of radical chemoradiotherapy. Adagrasib, in turn, will be available to patients with non-small cell lung cancer and a KRAS G12C mutation following failure of prior treatment. Experts emphasize that the growing number of targeted therapies increases the importance of molecular diagnostics based on next-generation sequencing (NGS).

Immunotherapy is also used to treat colorectal and liver cancer

The reimbursement list also includes the combination of nivolumab and ipilimumab for patients with advanced colorectal cancer with confirmed MSI-H or dMMR. “In the treatment of colorectal cancer, not only the tumor’s location but also its molecular profile is becoming increasingly important. For patients with MSI-H or dMMR, immunotherapy can be a particularly important treatment because it exploits the tumor’s specific biological susceptibility.” “This is a good example of how molecular diagnostics translates into a real-world treatment decision,” says Prof. Lucjan Wyrwicz, head of the Department of Oncology and Radiotherapy.

Another new development will be the reimbursement of combination immunotherapy with durvalumab and tremelimumab for adult patients with hepatocellular carcinoma. “We often diagnose the disease at an advanced stage. Combination immunotherapy using durvalumab and tremelimumab gives doctors another tool that can support treatment in patients with this difficult-to-treat cancer, in a group of patients who have contraindications to the combination therapy involving anti-angiogenic therapy that is commonly used today,” emphasizes Prof. Wyrwicz.

Dostarlimab will also be covered by reimbursement when used as first-line treatment for initially advanced or recurrent endometrial cancer with pMMR/MSS.

Greater Personalization of Prostate Cancer Treatment

The changes will also apply to the treatment of patients with metastatic hormone-sensitive prostate cancer. Darolutamide, used in combination with androgen deprivation therapy, will be covered. “This form of treatment was already available to patients with metastatic prostate cancer, but adding another drug from this group to the reimbursement program will allow for greater individualization of treatment and the selection of the drug best suited to a given patient, taking into account their comorbidities and other medications they are taking,” – emphasizes Prof. Jakub Kucharz, head of the Conservative Treatment Unit at the Clinic of Genitourinary Cancers.

A New Hope for Multiple Myeloma Patients

In hemato-oncology, belantamab mafodotin will be covered by reimbursement starting from the second line of treatment for refractory or relapsed multiple myeloma. “Multiple myeloma is a chronic disease in which many patients experience relapse or resistance—that is, a loss of response to previous treatment. Therefore, subsequent effective lines of therapy are of particular importance. The inclusion of belantamab in the reimbursement program means expanding treatment options for patients who require further management after previous therapies,” says Dr. Agnieszka Druzd-Sitek of the Lymphatic System Cancer Clinic. She adds that access to modern therapies as early as the initial treatment lines increases the chance of achieving a longer remission.

A New Treatment for Patients with a Rare Cancer

The reimbursement list also includes toripalimab, which is used to treat nasopharyngeal cancer following recurrence or metastasis. The drug has been recognized as a highly innovative technology.

– Nasopharyngeal cancer is a rare but clinically very challenging cancer, explains Dr. Bartosz Spławski, coordinator at the Head and Neck Cancer Clinic. He adds: – This is a positive and necessary change, because patients with rare head and neck cancers often have fewer treatment options available than those with more common cancers. In such situations, every reimbursement decision that expands access to modern therapy makes a real difference: it gives doctors an additional tool and patients a better chance at more effective treatment. This benefits not only individual patients but also the entire healthcare system, which, thanks to such decisions, can better address the needs of patients with rare diagnoses.

Getting Closer to Precision Medicine

Experts emphasize that successive updates to the reimbursement lists reflect the dynamic development of oncology and the increasingly rapid integration of scientific advances into everyday clinical practice. Cancer treatment is moving away from regimens based solely on tumor location and is increasingly taking into account the tumor’s molecular profile and the patient’s individual situation.

A greater number of reimbursed therapies means not only broader access to modern medications, but above all the ability to better tailor treatment to each individual patient. At the same time, the Ministry of Health has announced the implementation of new digital solutions in practice management systems, which are intended to make it easier for doctors to prescribe reimbursed medications and to access information on prices, generic alternatives, funding limits, and the availability of medications.

Source: NIO