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Cancer drug ruling ‘kick in teeth’

The decision not to offer a life-extending drug to prostate cancer sufferers until after they have received chemotherapy is a “kick in the teeth” for patients, a charity has said.

Prostate Cancer UK said that the drug could offer men extra time with loved ones and a chance to delay chemotherapy and its debilitating side effects.

The charity said t hat the National Institute for Health and Care Excellence’s (Nice) decision was “unjust”.

Meanwhile scientists have also expressed their disappointment over the health watchdog’s guidance not recommending the drug in this circumstance. Experts from The Institute of Cancer Research (ICR) said that there is clear evidence that abiraterone is beneficial for patients before they undergo chemo.

In final draft guidance, Nice said that the drug should not be widely used in the NHS in England to treat prostate cancer patients whose cancer has spread and who have previously received another type of hormone therapy before they are given chemotherapy.

A spokeswoman said that Nice already recommends the medication, made by drug company Janssen, for patients after they have undergone a certain type of chemotherapy.

Nice said that abiraterone, a lso known as Zytiga, is also “not cost effective at its current price”.

Prostate Cancer UK said that Janssen and Nice must continue negotiations until the “vital” drug is made available to patients .

Owen Sharp, chief executive of the charity, said: “It’s a fiasco. This decision is a kick in the teeth for men with advanced prostate cancer. For many this presented a vital opportunity for extra time with loved ones and a chance to delay chemotherapy and the debilitating side effects which come with it.

“An inflexible Nice process plus the drug company’s inability to produce all the requested data has led to this being just the latest in a string of hugely disappointing rulings on prostate cancer drugs. Once again men in England will have to take their chances with the Cancer Drugs Fund.

“The current system is flawed. It is not fit for purpose and it is the very people it is supposed to serve who are bearing the brunt. This decision is unjust and it needs to be overturned so that men in desperate need can receive the most effective drugs, wherever they live.

“We urge Janssen and Nice to get their act together and do whatever is necessary to get abiraterone pre-chemotherapy across the line without delay.”

Professor Paul Workman, interim chief executive of The Institute of Cancer Research, where the drug was discovered, said: “We’re very disappointed that men with prostate cancer will miss out on the chance to have abiraterone much earlier in their course of treatment as a consequence of this decision.

“There is clear evidence that use of abiraterone before chemotherapy is beneficial for patients, and gives them longer, healthier lives. We urge Nice and the drug’s manufacturer to get back to the table, and explore every option for making abiraterone available to these men at a price that is affordable for the NHS.

“Abiraterone maintains patients in a better state of health during the course of treatment than chemotherapy, and the increases in median survival it offers include much larger benefits for life expectancy in some men. Now men will have to wait until they are in the final stage of their lives before they can access this treatment, and men who are too frail to receive chemotherapy face not being able to receive abiraterone at all.”

Nice’s chief executive Sir Andrew Dillon said: “Nice has already recommended abiraterone as a treatment after docetaxel containing chemotherapy. In this appraisal, we have been considering it for an earlier stage in treatment. Abiraterone is not a new drug, but it is the first treatment of its type to become available prior to chemotherapy.

“We know how important it is for patients to have the option to delay chemotherapy and its associated side effects, so we are disappointed not to be able to recommend abiraterone for use in this way. However, the manufacturer’s own economic model demonstrated that the drug does not offer enough benefit to justify its price.”

Dr Peter Barnes, medical director at Janssen, said: “We are very disappointed with this decision which, if it stands, will leave thousands of men in England in the advanced stages of prostate cancer with no option but to accept chemotherapy – which they may not necessarily need or want yet – before being eligible to receive abiraterone routinely on the NHS.

“These men will eventually be able to receive abiraterone on the NHS after chemotherapy anyway, but will be denied the option of taking it earlier on in their illness.”

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