NICE Publishes Draft Guidance Recommending Enzalutamide for Prostate Cancer

Priscilla Lynch 

June 08, 2021

The National Institute for Health and Care Excellence (NICE) has published draft guidance on the use of the androgen receptor inhibitor enzalutamide (Xtandi, Astellas), plus androgen deprivation therapy (ADT), as an option for treating prostate cancer.

The draft guidance recommends enzalutamide plus ADT for treating metastatic hormone-sensitive prostate cancer in adults.

Current treatment for hormone-sensitive metastatic prostate cancer in the NHS is ADT alone, or docetaxel plus prednisolone or prednisone (from now, docetaxel) plus ADT.

Trial results suggest that, compared with ADT alone, enzalutamide plus ADT increases the time until the cancer progresses and how long people live.

Also, an indirect comparison suggests that, compared with docetaxel plus ADT, enzalutamide plus ADT increases the time until the cancer progresses.

Although it is unclear whether there is a difference between the two treatments in the length of time people live, the cost effectiveness estimates are within the range NICE considers to be an effective use of NHS resources.

Enzalutamide only received its licence for treating adults with this type of prostate cancer last month.

'Fantastic News'

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: "Enzalutamide plus ADT offers another option for people with hormone-sensitive metastatic prostate cancer, especially for people who cannot have docetaxel, or who choose not to have it because of its side-effects. Also, it is taken by mouth so is more convenient than docetaxel, which is an intravenous treatment."

The interim arrangements for cancer treatments during the COVID-19 pandemic include the option of giving enzalutamide plus ADT instead of docetaxel at this stage of the treatment pathway to reduce toxicity and potential for hospital admission.

Once published the NICE guidance will supersede this interim arrangement.

Angela Culhane, chief executive, Prostate Cancer UK, commented: "This is fantastic news for thousands of men with advanced prostate cancer, especially those who have additional illnesses that make them unsuitable for chemotherapy.  It finally guarantees them access to a treatment which is just as effective as chemotherapy and can give them back precious time with their families."

This article originally appeared on Univadis, part of the Medscape Professional Network.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: