The ICR responds to approval of abiraterone as first-line treatment for advanced prostate cancer on the NHS in Scotland

The Institute of Cancer Research, London, strongly welcomes the recommendation by the Scottish Medicines Consortium (SMC) to make the prostate cancer drug abiraterone, when given alongside hormone therapy, available to men with advanced prostate cancer as first-line treatment on the NHS in Scotland.

Experts at The Institute of Cancer Research (ICR) are now calling for other NHS regulators, including NICE, to follow suit so that men with advanced prostate cancer can benefit from abiraterone earlier – no matter where they live in the UK.

Abiraterone was discovered at the ICR and developed in clinical trials with its hospital partner The Royal Marsden NHS Foundation Trust.

In 2017 the European drugs regulator – the European Medicines Agency – approved abiraterone as a first-line treatment for advanced prostate cancer, alongside hormone therapy.

Abiraterone (which has the brand name Zytiga) is a highly innovative drug which has extended the lives of hundreds of thousands of men around the world, and was celebrated in 2018 as one of the greatest research achievements in the 70-year history of the NHS by the National Institute for Health Research.

But the NHS standard of care is to use docetaxel chemotherapy alongside hormone therapy, or hormone therapy alone, as first-line treatment for newly diagnosed advanced prostate cancer, and abiraterone is only approved for use before chemotherapy in men for whom hormone therapy has failed.

Professor Nicholas James, Team Leader in 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.

Professor James said:

“Our STAMPEDE clinical trial results very clearly showed major benefits in survival for abiraterone, used in combination with hormone therapy, in men with advanced prostate cancer. This built on earlier results from STAMPEDE showing similar benefits with docetaxel chemotherapy.

“Not only does abiraterone extend lives but it also halved the risk of serious complications such as bone fractures and spinal cord problems from cancer. Time to relapse was also substantially delayed. Taking all these advantages together, using abiraterone at diagnosis is significantly better for both a patient’s quality and quantity of life than using standard hormone therapy alone, and delaying use of abiraterone, or other treatments such as chemotherapy, until the patient relapses.

“We therefore now have two life-prolonging therapies, with differing pros and cons available to men with newly diagnosed prostate cancer that has spread.

“The SMC’s decision means that straight after men with advanced prostate cancer are diagnosed, doctors in Scotland can give them abiraterone, which is taken as a pill with modest additional side effects compared to standard hormone therapy alone, which is the treatment that 75% of men currently receive in this setting. The evidence is clear that regulators should make the same decision for the benefit of men diagnosed with advanced prostate cancer across the UK.”

The STAMPEDE clinical trial is led by the MRC Clinical Trials Unit at UCL.

Professor Robert Huddart, Professor of Urological Cancer at The Institute of Cancer Research, London, and Consultant in Urological Oncology at The Royal Marsden NHS Foundation Trust, said:

“This is excellent news for men in Scotland with advanced prostate cancer, who can now benefit from abiraterone earlier in the course of their treatment, and potentially be spared the need for chemotherapy. That is especially important for older patients who are either not well enough to receive chemotherapy or are put at significant risk by doing so.

“This decision by the SMC should improve access to abiraterone and increase survival in Scotland for men with advanced prostate cancer. NICE is currently considering whether to make the same recommendation in England and Wales and I very much hope it will follow suit. Abiraterone was discovered and developed here in the UK, and men in every part of the UK should be able to benefit fully from it.”

Rob Lester, a retired GP, aged 63 from Fife in Scotland, is currently receiving abiraterone as a first-line treatment for advanced prostate cancer through the STAMPEDE clinical trial. He said:

“This is very welcome news for men living in Scotland who have been newly diagnosed with advanced prostate cancer. When I was first diagnosed, I only hoped I would survive five years. It’s now been almost eight years, and I’m still here. Abiraterone has given me hope – not only have I survived, but I’ve been able to enjoy my life.

“The clinical trials have shown that abiraterone can be very effective in delaying the progress of advanced prostate cancer without men having to go through chemotherapy. I’m really pleased that more men like me could now be able to benefit from abiraterone and be given that hope and that opportunity to live their lives.”

The ICR – a charity and research institute – has less than £10 million left to raise of a £75 million investment in a new Centre for Cancer Drug Discovery, which will be focused on creating a new generation of ‘anti-evolution’ treatments. Find out more at ICR.ac.uk/LetsFinishCancer