Responding to draft NICE guidance rejecting the use of abiraterone for advanced prostate cancer before chemotherapy, Professor Paul Workman, Deputy Chief Executive of The Institute of Cancer Research, London, said:

“We are very disappointed that NICE has not felt able to recommend use of abiraterone for men with prostate cancer who are yet to receive chemotherapy. Abiraterone, which was discovered and developed here at The Institute of Cancer Research, is now used as standard after chemotherapy and has extended the lives of thousands of men in the UK with advanced prostate cancer, with fewer side-effects than chemotherapy. The decision to refuse use of abiraterone before chemotherapy will deny many thousands of men the opportunity to access the drug earlier in their course of treatment. It is a particular blow for men who are unable to have chemotherapy because they are too old or too frail, since they could now miss out on abiraterone too.

“We believe the evidence is clear that abiraterone is effective when given before chemotherapy and can give men many months of extra life free of disease, and improved quality of life. NICE appears to have made its decision on the basis of cost, and we recognise that it does have a responsibility to achieve cost-effectiveness for the NHS. It is disappointing that abiraterone was considered too expensive to be recommended before chemotherapy, and we would urge NICE, the NHS and the manufacturer to reach an accommodation on the drug’s price as soon as possible, so that it can be made more widely available.

“Abiraterone has in part been a victim of the success of prostate cancer medicine, since men who have not yet received chemotherapy now live for longer than two years, meaning NICE could not apply its end of life criteria. We believe there is a need to put greater emphasis on innovation when evaluating treatments, so that highly innovative drugs like abiraterone do not lose out to ‘me too’ drugs that merely replicate the actions of existing treatments.”

Source: The Institute of Cancer Research