The Scottish Medicines Commission have recently approved the use of Abiraterone earlier in the treatment pathway for prostate cancer.
This approval is specifically for patients with newly diagnosed, high risk, metastatic, hormone sensitive prostatic cancer. Or to put it more simply, patients who have just been diagnosed with significant advanced disease who would normally just be treated with hormone therapy (Androgen Deprivation Therapy / ADT) as a single treatment agent.
It has become apparent through a number of trials such as STAMPEDE and LATITUDE that better treatment outcomes, reduced progression of disease and increased length of survival can be achieved by no longer relying on mono-therapy with ADT but with combined therapy with ADT and a second drug.
The treatment pathway currently used is a combination of ADT and chemotherapy i.e. Docetaxel. Docetaxel is not specifically licensed for this use, but by common consent is considered suitable for use in this way. The studies showed that equally good or better results can be gained by using Abiraterone instead of Docetaxel. There are a number of medical / clinical reasons why patients may be better treated with Abiraterone rather than Docetaxel. This approval by the SMC now adds another alternative to the treatment pathway and quite rightly gives patients the possibility of treatment choice. Tackle strongly believes that patient choice is an important part of the decision process for treatment.
This is a major step forward in the treatment that can now be offered to men in Scotland who have advanced disease at the time of initial diagnosis. The SMC are to be applauded for making this decision.
Currently an identical appraisal process is going through NICE – the English body equivalent to the SMC. This decision process is lengthy and has yet to reach a final conclusion. The decisions made by the SMC are not automatically mirrored by NICE. There is no guarantee that the same treatment pathway will be made available to men in England. If approval is not gained from NICE, then there will obviously be a serious discrepancy in treatments available to men within the UK.
Tackle will keep a close involvement and will update members as soon as there is further information available.