NHS England widens access to life-extending treatment for prostate cancer

Patients first diagnosed with advanced prostate cancer will now get immediate access to a drug which studies have shown can extend their life by more than a year compared to current options, NHS England has announced.

Following a review of evidence from two trials published late last year, specialists will now be able to prescribe the chemotherapy drug docetaxel as soon as someone is diagnosed with incurable prostate cancer. Under previous guidelines, patients had to wait until it was clear that existing, hormone-based treatments had stopped having an effect.

The two randomised control trials published in 2015 found that, compared with androgen deprivation therapy (ADT) alone, docetaxel combined with ADT improved overall survival by up to 15 months.

NHS England’s Director of Specialised Services, Dr Jonathan Fielden, said: “Rigorous new evidence shows that this drug brings significant benefits for patients with advanced prostate cancer. So working closely with patient groups and cancer specialists, NHS England is now pleased to be fast-tracking its wider availability. NHS cancer outcomes are now better than ever, and we’re on track for very substantial further patient gains over the next five years.”

Angela Culhane, Chief Executive at Prostate Cancer UK said:  “Today’s announcement is great news for men who are newly diagnosed with advanced prostate cancer that has spread. This fast-track response to new evidence indicates what can be achieved when there is the will in the system. It must set a precedent for other treatments that demonstrate clear clinical benefit when used in different ways.

“It is now critical that specialists are made aware that this use of docetaxel treatment is available so that no man ever misses out. Earlier docetaxel must become the standard for men who can benefit from it and we will continue applying pressure until we are sure this is the case.”

Prostate cancer is the most common cancer in men in the UK, affecting around 1 in 8 men at some point in their lives. Older men, men with a family history of prostate cancer and Black men are more at risk of being diagnosed with the disease.

More than 38,000 men are diagnosed with prostate cancer and more than 9,000 men die from the disease every year in England. At the point of diagnosis approximately 4,560 (12%) of cases are advanced, or metastatic – for which there is no cure.

Prostate cancer can spread to any part of the body, but it most commonly spreads to the bones and lymph nodes. Advanced (metastatic) prostate cancer can cause symptoms such as bone pain, loss of well-being and problems urinating.

It is not possible to cure advanced prostate cancer but treatments, such as initial hormone therapy can keep it under control, sometimes for several years.

Docetaxel chemotherapy is a routine treatment for men with advanced prostate cancer. However, under current guidelines (NICE TA101), it is prescribed only after men have become resistant to ADT. Under this new policy from NHS England, based on the new evidence available, men with advanced prostate cancer will be able to receive docetaxel at the same time as starting ADT.

In line with the current evidence base, this policy does not cover those who initially received treatment for early stage prostate cancer.

The policy, which has been developed by NHS England’s Clinical Reference Group for Chemotherapy with support from clinicians and patient representatives, will be reviewed later in the year in line with all policies approved outside of the annual specialised commissioning prioritisation process.