Men with high-risk locally advanced prostate cancer in England will soon be offered the drug abiraterone on the NHS, following landmark findings from the UCL-led STAMPEDE trial.
NHS England announced today that newly diagnosed men, whose prostate cancer has not spread, will be able to receive the hormone therapy abiraterone within weeks. Patients with similar risk profiles in Wales and Scotland already have access to the drug on the NHS.
The groundbreaking STAMPEDE trial showed that adding abiraterone to the standard treatment, for men with high-risk non-metastatic cancer, could halve the risk of death from the disease and slow overall progression.
Responding to the news, trial co-lead Professor Gert Attard (UCL Cancer Institute) said: "This is a hugely welcome moment for patients. Our research showed clearly that abiraterone can save lives when offered earlier to men at high risk of their cancer spreading.
"Funding for this disease indication is already available in Scotland and Wales, so we are delighted that NHS England has acted on this evidence and will now make this highly effective treatment routinely available."
In England, around 8,000 men will be eligible for the drug every year and, within this group, it will reduce deaths from prostate cancer by around 50%, from about 1,900 to fewer than 1,000.
Abiraterone works by stopping the cancer spreading by starving the disease of the hormones it needs to grow, such as testosterone. The drug is given in combination with a steroid called prednisolone, and will be given alongside standard care treatments, including androgen-deprivation therapy (ADT) and radiotherapy.
Up to now, abiraterone has been used for patients with advanced prostate cancer which has spread to other parts of the body. It’s also given to men whose cancer has stopped responding to standard hormone treatment.
In total, more than 52,000 people are diagnosed with prostate cancer every year in the UK, and around 12,000 patients are considered at ’high risk’ of their cancer spreading.
Groundbreaking evidence from the STAMPEDE trial
The decision follows findings from the UCL-sponsored STAMPEDE trial, led by researchers at UCL Cancer Institute, working alongside the Institute of Cancer Research, London and funded by Cancer Research UK and the MRC.
A total of 1,974 patients were enrolled across two arms of the trial. 988 were given the current standard treatment, while 986 patients were given the standard treatment combined with abiraterone.
After six years of monitoring, the proportion of men alive on abiraterone was 86% compared to 77% on standard treatment (hormone therapy with or without radiotherapy). This equates to a 12% increase in survival rate at six years.
In addition, abiraterone reduced the risk of disease progression or metastasis by nearly half, with 82% of men progression-free (meaning the cancer hadn’t spread) at six years compared with 69% on standard treatment.
These transformative results were subsequently incorporated into clinical guidelines internationally and have now driven change at a national level in England.
Professor Attard, who is Director of the UCL Cancer Institute and also honorary medical oncology consultant at UCLH, added: "This latest NHS decision marks one of STAMPEDE’s most significant impacts yet- a direct example of UCL-led science reshaping national cancer care and improving survival for thousands of men each year."
Researchers at The Institute of Cancer Research (ICR) with funding from Cancer Research UK discovered abiraterone and developed it with colleagues at The Royal Marsden.
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Henry Killworth
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