NHS looks at drug that may halve risk of prostate cancer death for some patients
A drug which could halve the risk of death from some prostate cancers may become available on the NHS.
It has been found that a hormone therapy drug called abiraterone could be effective if added to the standard treatment for locally advanced prostate cancer, which looks likely to spread.
Abiraterone is currently being used for patients with advanced prostate cancer which has spread to other parts of the body. It is also given to people who have stopped responding to standard hormone treatment. The drug is given in combination with a steroid called prednisolone.
More than 52,000 people are diagnosed with prostate cancer every year in the UK, and around 22,000 patients are considered at “high-risk” of their cancer spreading.
NHS England is now considering using the drug on patients after researchers found that hormone therapy using abiraterone with prednisolone could significantly reduce prostate cancer deaths and improve outcomes for thousands of people every year.
It follows a six-year study of patients, known as the Stampede trial, which was led by a team at University College London and The Institute of Cancer Research, London.
The study, published in the Lancet, indicates that using abiraterone to treat earlier stage prostate cancer could extend lives and prevent the cancer from spreading.
A total of 1,974 patients took part in the trial, including 988 who were given the current standard treatment and 986 who had the standard treatment combined with abiraterone.
Around half of those in the abiraterone group were also given another hormone therapy called enzalutamide.
The researchers found that adding abiraterone alone, or using it with enzalutamide, to standard prostate cancer treatment improved survival and decreased the chance of the cancer spreading.
There were 7% of men who received abiraterone who died from prostate cancer during the six-year follow-up period, compared with 15% of those who had been given the standard care.
There were 527 men in the abiraterone group who also received enzalutamide, but the study found that using this combination of drugs did not further improve outcomes beyond those who were given abiraterone on its own.
It also caused an increase in side effects.
The next step is for the National Institute for Health and Care Excellence (Nice) – which produces evidence-based guidance and advice for health, public health and social care practitioners – to consider and implement the findings from the research, according to study co-leader Professor Nick James of The Institute of Cancer Research.
Prof James, who was the chief investigator of the Stampede trial, said: “Currently, abiraterone is only given to patients with very advanced prostate cancer.
“Our latest findings are the first to show the drug can also benefit men whose cancer is at an earlier stage – improving survival and reducing the chance of progression.”
Study co-leader Professor Gert Attard, of the UCL Cancer Institute, said: “This is the first trial of a treatment added to standard hormone therapy and radiotherapy since they started to be used together 15 years ago that significantly increases the proportion of men seeing good outcomes after prostate cancer.
“With careful patient selection, two years of abiraterone added to standard treatment can significantly reduce the burden on patients and the NHS from disease relapse that currently causes so much suffering.”
The Stampede trial has recruited more than 10,000 patients and has led to 29 changes in clinical practice across the world, directly influencing the treatment of people with prostate cancer.
Cancer Research UK chief executive Michelle Mitchell said: “It’s great to see that yet more people with prostate cancer could soon see benefit from this innovative research.”
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