Give prostate cancer patients drug that halves risk of death, NHS told
British scientists have used AI to identify which men could most benefit from a treatment which is currently denied by the NHS in England.
Researchers found that one in four men with high-risk prostate cancer, which has not yet spread, could see their risk of death halved if they were given the hormone treatment abiraterone.
The rest could be spared such treatment, which can cause distressing side effects including loss of libido, as well as fatigue and weakness.
The drug is routinely offered to men in Scotland and Wales with newly diagnosed high-risk prostate cancer which has not yet spread.
However, the NHS refuses to fund it in England, even though it costs just £2.75 a day.
As a result, around 8,400 men a year are denied the drug, which is only given to some men with advanced disease.
Prostate cancer in numbers
The new study shows just how powerful the drug can be if targeted at the right candidates, in conjunction with standard therapy - cutting deaths by half among those with aggressive disease, while slashing the cost to the NHS.
Experts said the findings from The Institute of Cancer Research, London, and University College London (UCL) should prompt NHS officials to review the funding of the drug.
The results will be presented at the American Society of Clinical Oncology (ASCO) Annual Meeting [MUST KEEP] which opens in Chicago on Friday.
Abiraterone, discovered in the UK at The Institute of Cancer Research (ICR), works by inhibiting the production of testosterone in all tissues throughout the body, including in the tumour.
The new test, developed by Artera Inc,. uses artificial intelligence to study images of tumour samples and pick out features that are invisible to the human eye.
It was tested on biopsy images from more than 1,000 men with prostate cancer who were taking part in a major trial.
Men were given a score depending on whether their disease was fuelled by male hormones known as androgens.
In cases which were fuelled by the hormones - which makes the disease more aggressive - giving men abiraterone cut the risk of death after five years from 17 per cent to 9 per cent.
Prostate cancer cases and rates
In cases which were not, the risk went from 7 to 4 per cent among those given the drug, which experts said was not statistically or clinically significant.
Such men would benefit from standard treatment, which would spare them the side effects which come with abiraterone, experts said.
The current research received funding from Artera Inc., UK MRC and Prostate Cancer UK.
Professor Nick James, Professor of Prostate and Bladder Cancer Research at The Institute of Cancer Research, London, who co-led the study said that the drug had already been found to have 'spectacular results' for many men.
He said the new findings allowed the treatment to be far more narrowly targeted, to pick out those who would respond best, and spare others from side effects.
The Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust said access to the life extending drug was currently 'a postcode lottery' despite the fact the drug costs just £2.75 a day.
He urged NHS England to fund the drugs.
Professor Kristian Helin, Chief Executive of The Institute of Cancer Research, said: 'Abiraterone has been a game changer for treatment of prostate cancer, and I'm proud of the ICR's role in discovering and testing this drug which has extended the lives of so many men.
'Alongside our mission to find smarter, kinder treatments, we must ensure we are matching the right drugs to the right patients. This research, using artificial intelligence, provides an innovative route to testing prostate cancer patients to determine their treatment. I hope that this can be implemented so that all men with prostate cancer who will benefit from abiraterone can do so.'
Study co-leader Professor Gert Attard, at the UCL Cancer Institute said advanced and aggressive prostate cancer could take a 'highly variable' path, with the new evidence showing how algorithms could extract information from routinely available pathology slides to tailor these treatments to specific patients.
Dr Matthew Hobbs, Director of Research at Prostate Cancer UK, said: 'Prostate Cancer UK has been calling on the UK Government to approve this life-saving, cost-effective drug for over two years. These exciting results suggest a way to make this an even more cost-effective approach. We therefore echo the researchers' urgent call for abiraterone to be made available to those men whose lives it can save – men who, thanks to this research, we can now identify more precisely than ever before.'
'Treatment has cost me £20,000 so far'
Giles Turner, 64, who lives in Brighton, was diagnosed with prostate cancer in March 2023.
He has been taking abiraterone for almost two years and has spent £20,000 on his treatment so far.
He said: 'This is great research and adds even more reason for NHS England to start funding this treatment now.
'I find it very difficult to come to terms with having to pay for this treatment whereas if I was with the NHS in Scotland or Wales I would not.
'Even more importantly are the thousands of men in England who are missing out on this cheap, life-saving and cost-saving drug. Action must be taken by NHS England and DHSC right now.'
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