NHS England has given the green light for abiraterone to be used to treat men with prostate cancer that has not metastasised.
It is the first time the drug will be available for these patients in England, bringing the country into line with Wales and Scotland, which approved the treatment in 2023.
Around 2000 men diagnosed in the past 3 months with non-metastatic disease will be eligible if the drug is clinically appropriate, NHS England said. A further 7000 men a year are expected to be diagnosed with the same condition and will now be able to access the drug.
Prostate Cancer UK, which has campaigned for wider access to the drug, said the “cheap, yet lifesaving” treatment would save 3000 lives by 2030.
NHS England said thousands of men would be offered abiraterone on the NHS within weeks.
How the Drug Works
Abiraterone blocks testosterone production by inhibiting the CYP17 enzyme in the testes, adrenal glands, and tumour tissue, depriving cancer cells of the hormones they need to grow. While it is not curative, it can slow disease progression.
Evidence from the STAMPEDE trial in 2022 showed that a 2-year course of abiraterone in men with high-risk, non-metastatic prostate cancer reduced the risk of recurrence and death.
Professor Nick James, of the Institute of Cancer Research in London, said the study showed that 2 years of abiraterone halved the risk of prostate cancer returning and cut the risk for death by 40%.
Cost and Access
The drug’s patent expired in 2022, reducing its cost to the NHS from thousands of pounds to less than £2.50 per day. Scotland and Wales subsequently approved its use in this group of patients.
The decision for men in England is “momentous,” said Amy Rylance, assistant director of health improvement at Prostate Cancer UK.
The charity said it would “continue to push” for men in Northern Ireland to be offered the treatment on the same basis.
“Even for men whose cancer does recur, this treatment gives them more healthy years,” James said, adding that fewer relapses would also save the NHS money in the long term.
Rob Hicks is a retired National Health Service doctor. A well-known TV and radio broadcaster, he has written several books and has regularly contributed to national newspapers, magazines, and online publications. He is based in the United Kingdom.
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