A life-extending treatment for an aggressive form of cancer has been given the green light for NHS use, offering new hope to patients battling bile duct cancer. Health officials have recommended zanidatamab for those diagnosed with cholangiocarcinoma, a disease often identified at a late stage when surgical removal is no longer an option.
Clinical trials indicate that the new treatment could almost triple the life expectancy of patients compared with existing therapies. This is particularly significant given that fewer than one in three people diagnosed in England survive a year post-diagnosis, and treatment options have historically been limited.
The news has been welcomed by patients and their families, including the relatives of Huw Jones, who campaigned for the drug’s widespread availability before his death earlier this year. Mr Jones, 33, from Llanuwchllyn in north Wales, was diagnosed with stage 4 cholangiocarcinoma in 2024 after experiencing pain following triathlon training. His diagnosis came the day before his partner’s 20-week scan for their first child.
He began taking zanidatamab as part of a clinical trial in January 2025, the same month his son, Idris, was born. His family firmly believes the drug allowed them to spend a precious year together as a family of three. Following his death, his family continued his fight for NHS approval.
Huw’s father, Gareth Jones, said: “Although we all wish Huw was still with us, we are grateful for the way in which zanidatamab gave him precious time with his new son, Idris, and the rest of our family. It also gave him much-needed hope during treatment for cholangiocarcinoma. Too often patients with this cancer are presented with little or no options, so knowing that this treatment can now be accessed through the NHS is excellent news for people with HER2-positive cholangiocarcinoma in England and Wales.”
Gareth Honeybone, an NHS surgeon from Sheffield and fellow cholangiocarcinoma patient, echoed these sentiments. After his initial tumour was surgically removed and he received chemotherapy, a new tumour was detected in August 2024. Following further chemotherapy and immunotherapy, Mr Honeybone started zanidatamab in January 2025 through a clinical trial, and subsequent scans have shown the tumour is no longer visible.
Mr Honeybone stated: “I am pleased to hear that zanidatamab has been recommended for approval. I am proud that my success with the drug has contributed to more patients and families being able to experience the benefits I have.”
The National Institute for Health and Care Excellence (Nice) initially rejected the treatment in draft guidance but has now approved it in its final draft for patients with HER2-positive advanced biliary tract cancer who have already undergone at least one prior treatment.
Also known as Ziihera, the antibody treatment targets a protein called HER2, which stimulates tumour growth. It works by activating the immune system to eliminate cancer cells and reduces HER2 levels, thereby preventing further growth. Clinical trial data revealed that patients treated with zanidatamab survived an average of 18.1 months, compared to 6.2 months for those on current second-line treatments.
Helen Knight, director of medicines evaluation at Nice, commented: “I am pleased we have been able to recommend this effective new treatment option, the first HER2-targeted drug Nice has recommended for people with biliary tract cancer in England. Patients and clinical experts involved in the appraisal told us how this treatment would make a huge difference by extending people’s lives and improving their quality of life – something that was not always possible with chemotherapy.”
Helen Morement, chief executive of the cholangiocarcinoma charity AMMF, added: “During Nice’s appraisal, we heard from patients and their families about the positive difference zanidatamab provided for them. We are therefore pleased that more people with advanced HER2-positive disease will be able to access this life-extending treatment through the NHS.”
Nice estimates that approximately 65 patients annually will benefit from the treatment, which is administered via an intravenous drip every two weeks. Manufacturer Jazz Pharmaceuticals has made zanidatamab available to the NHS with a discount through a commercial agreement.
