The Institute of Cancer Research (ICR) has praised the approval of targeted hormone therapies, enzalutamide and abiraterone, as first-line NHS treatments for men with advanced prostate cancer.
But the ICR was also critical of NHS England for taking so long over its recommendation, and for limiting use of abiraterone only to patients who could not take enzalutamide. Standard treatment for men when they are first diagnosed with advanced prostate cancer is hormone therapy, either on its own, or together with docetaxel chemotherapy.
Treatment with enzalutamide or abiraterone can not only prevent patients having to receive docetaxel chemotherapy but is also given as tablets which men can take at home – avoiding unnecessary pressures on the NHS.
NHS England has updated its interim guidance on treatment change options during the Covid-19 pandemic to offer enzalutamide for men with newly diagnosed, advanced prostate cancer, and abiraterone for patients who cannot tolerate enzalutamide.
Abiraterone is a highly innovative treatment which was discovered at The Institute of Cancer Research (ICR), and was jointly developed with The Royal Marsden NHS Foundation Trust. The ICR and The Royal Marsden also led a major phase III clinical trial of enzalutamide.
Two large clinical trials, STAMPEDE and LATITUDE, found that men given abiraterone as a first-line treatment lived longer, and had a better quality of life, than those given hormone therapy with docetaxel chemotherapy.
Abiraterone was licensed as a first-line treatment by the European Medicines Agency (EMA) in 2017, and was recommended in Scotland as a first-line treatment for advanced prostate cancer earlier this year.
However, in England and Wales, it has only been available to treat men for whom hormone therapy has stopped working.
In light of the Covid-19 pandemic, the ICR’s Professor Nick James and more than 80 colleagues across the UK wrote to NHS England and the Cancer Drugs Fund urging them to widen earlier access to abiraterone for men across the UK.
Professor Nick James, Professor of Prostate and Bladder Cancer Research at The Institute of Cancer Research, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, is Chief Investigator of the STAMPEDE clinical trial, which is exploring the best way to treat newly diagnosed advanced prostate cancer.