UCLH-supported research leads to new NHS treatment for high-risk prostate cancer

Men with high risk locally advanced prostate cancer in England will soon be offered the drug abiraterone on the NHS, following landmark findings from a clinical trial co-led by an oncology consultant at UCLH.

Newly diagnosed men whose prostate cancer has not spread will be able to receive the hormone-therapy within weeks, NHS England (NHSE) announced today. Professor Peter Johnson, NHSE national clinical director for cancer, gave an exclusive interview to the BBC from UCLH to announce the change in practice. Patients with similar risk profiles in Wales and Scotland already have access to the drug on the NHS.

Professor Johnson said: “For thousands of men with prostate cancer, this treatment option could be life-changing by helping keep their cancer at bay for several years.

“The life-extending treatment available on the NHS within weeks will mean thousands of men can kickstart their year with the news that they will have a better chance of living longer and healthier lives. 

“The NHS will continue to work hard to offer people the most effective and evidence-based treatments, with several new prostate cancer drugs rolled over the last five years.”

The shift in policy comes after the groundbreaking STAMPEDE trial co-led by UCLH oncologist Gert Attard showed that adding abiraterone to the standard treatment, for men with high-risk non-metastatic cancer, could halve the risk of death from the disease and slow overall progression.

Responding to the news, Professor Attard, who is also director of the UCL Cancer Institute, said: “This is a hugely welcome moment for patients. Our research showed clearly that abiraterone can save lives when offered earlier to men at high risk of their cancer spreading. 

“Funding for this disease indication is already available in Scotland and Wales, so we are delighted that NHS England has acted on this evidence and will now make this highly effective treatment routinely available.”

In England, around 8,000 men will be eligible for the drug every year and, within this group, it will reduce deaths from prostate cancer by 50%, from about 1,900 to fewer than 1,000. 

Abiraterone works by stopping the cancer spreading by starving the disease of the hormones it needs to grow, such as testosterone. The drug is given in combination with a steroid called prednisolone, and will be given alongside standard care treatments, including androgendeprivation therapy (ADT) and radiotherapy (RT).

Up to now, abiraterone has been used for patients with advanced prostate cancer which has spread to other parts of the body. It’s also given to men whose cancer has stopped responding to standard hormone treatment.

In total, more than 52,000 people are diagnosed with prostate cancer every year in the UK, and around 12,000 patients are considered at ‘high-risk’ of their cancer spreading.

The UCL-sponsored STAMPEDE trial was led by researchers at the UCL Cancer Institute, working alongside the Institute of Cancer Research, London and funded by Cancer Research UK and the MRC.

A total of 1,974 patients were enrolled across two arms of the trial. 988 were given the current standard treatment, while 986 patients were given the standard treatment combined with abiraterone. 

After six years of monitoring, the proportion of men alive on abiraterone was 86% compared to 77% on standard treatment (hormone therapy with or without radiotherapy). This equates to a 12% increase in survival rate at six years. 

In addition, abiraterone reduced the risk of disease progression or metastasis by nearly half, with 82% of men progression free (meaning the cancer hadn’t spread) at six years compared with 69% on standard treatment.

These transformative results were subsequently incorporated into clinical guidelines internationally and have now driven change at a national level in England.

Professor Attard, whose research is supported by the NIHR UCLH Biomedical Research Centre, added: “This latest NHS decision marks one of STAMPEDE’s most significant impacts yet – a direct example of UCL-led science reshaping national cancer care and improving survival for thousands of men each year.”

Health and Social Care Secretary Wes Streeting said: “When you're living with prostate cancer, every day with your loved ones matters. I’m delighted the NHS have taken the steps needed to make the drug available, giving thousands of men access to abiraterone – a treatment that significantly improves survival rates and can give patients precious extra years of life.

“We're backing the best clinical evidence, making smart funding decisions, and ensuring patients get the care they need when they need it most.

“We're serious about improving prostate cancer outcomes - treating it faster and giving loved ones more time together."

Researchers at The Institute of Cancer Research (ICR) with funding from Cancer Research UK discovered abiraterone and developed it with colleagues at The Royal Marsden.