The new edition of the WHO Model Lists of Essential Medicines contains four news medicines for cancer treatment:
- Enzalutamide, as an alternative to abiraterone, for prostate cancer;
- Everolimus, for subependymal giant cell astrocytoma (SEGA), a type of brain tumour in children;
- Ibrutinib, a targeted medicine for chronic lymphocytic leukaemia; and
- Rasburicase, for tumour lysis syndrome, a serious complication of some cancer treatments.
The listing for imatinib was extended to include targeted treatment of leukaemia. New childhood cancer indications were added for 16 medicines already listed, including for low-grade glioma, the most common form of brain tumour in children.
A group of antibodies that enhance the immune response to tumour cells, called PD-1 / PD-L1 immune-checkpoint inhibitors, were not recommended for listing for the treatment of a number of lung cancers, despite being effective, mainly because of their exceedingly high price and concerns that they are difficult to manage in low-resourced health systems. Other cancer medicines were not recommended for listing due to uncertain additional clinical benefit compared with already listed medicines, high price, and management issues in low-resource settings. These included osimertinib for lung cancer, daratumumab for multiple myeloma, and three types of treatment (CDK4/6 inhibitors, fulvestrant and pertuzumab) for breast cancer.