Prostate cancer cell. Credit: LRI EM Unit.
A hormone therapy will now be available for some people with newly diagnosed, advanced prostate cancer in Scotland for the first time.
The latest decision by the Scottish Medicine Consortium (SMC) means abiraterone (Zytiga) will now be an option for people whose hormone sensitive prostate cancer has spread to other parts of the body, in combination with steroids and another hormone therapy.
Emma Greenwood, Cancer Research UK’s director of policy, called the decision “fantastic news”.
“Our research played a leading role in the discovery and development of abiraterone, so it’s really great to see it is being made available to more people in Scotland with advanced prostate cancer to give them more time with their families and friends.”
The latest batch of SMC decisions also included a targeted cancer therapy, which has been given the green light to treat some people with skin lymphoma.
Really good news for people with prostate cancer
Abiraterone is a hormone therapy used to treat prostate cancer that’s spread to other parts of the body. Until now, it’s been used to treat patients when other hormone treatments have stopped working, or after chemotherapy.
This decision means that, for the first time, the drug can be used as a treatment in newly diagnosed prostate cancer.
Clinical trials have compared a combination of abiraterone, anti-androgen therapy and steroids with anti-androgen therapy and a dummy drug (placebo). People taking the abieraterone combo lived for significantly longer than those taking a placebo (53.3 months vs 36.5 months).
The drug is still being reviewed for this group of patients in England by the National Institute of Health and Care Excellence.
Targeted treatment approved for skin lymphoma
Brentuximab vedotin (Adcetris) was also approved by the Scottish Medicines Consortium to treat some people with a type of skin lymphoma, called CD30-positive cutaneous T-cell lymphoma (CTCL).
CTCL is a form of non-Hodgkin lymphoma that affects the skin. It typically develops as flat red patches on the skin’s surface, which can then develop into tumours.
The drug will now be an option for people whose lymphoma has come back or got worse after one round of treatment, after it was found to stop the disease getting worse. It will be available for the two most common types of skin lymphoma, mycosis fungoides and Sezary syndrome, as well as primary cutaneous anaplastic large cell lymphoma.
Standard treatment for NHS patients with this type of lymphoma is the chemotherapy drug methotrexate or another drug called bexarotene. But in a trial of 128 patients with CTCL, brentuximab vedotin was found to be more effective at shrinking tumours over a four month period.
People taking brentuximab vedotin also reported fewer severe side effects than those taking standard treatments. But brentuximab vedotin affected the nervous system in a large proportion of patients, with 44 out of 64 patients experiencing a tingling or pain sensation in the fingertips or toes, called peripheral neuropathy.
The drug was approved for use in England in March 2019. NICE decisions are usually adopted in Wales and Northern Ireland as well as England, so the drug is likely to be available in all 3 nations.