During the pandemic, Astellas’ oral prostate cancer drug Xtandi scored an interim nod in England as a “COVID friendly” way to treat men at home instead of in hospitals. With the pandemic easing there, cost watchdogs are backing the drug's use for thousands of patients, offering the company an edge over its rival Johnson & Johnson.
The National Institute for Health and Care Excellence (NICE) recommended the once-daily oral drug, also known as enzalutamide, to treat patients with metastatic hormone-sensitive prostate cancer (mHSPC) along with standard androgen deprivation therapy (ADT).
The decision is a leg up for the Japanese pharma over its rival Erleada from Johnson & Johnson, which cost watchdogs rejected at the end of May. NICE also turned away J&J’s other prostate drug Zytiga last year.
Xtandi’s NICE endorsement means thousands of men with prostate cancer in the U.K. who are unsuitable for the standard chemotherapy treatment docetaxel will have a new option, Prostate Cancer U.K. said in a statement.
Around 8,500 people in England could now be eligible for treatment with Xtandi, NICE said. The drug is designed to block the effect of testosterone on prostate cancer cells. Without testosterone, the cells can’t grow, even if they’ve spread to other parts of the body.
The agency based its decision on Xtandi’s late-stage clinical trials, which showed the androgen receptor inhibitor paired with ADT helped slow disease progression in prostate cancer patients by 61% compared with placebo and ADT. The drug was also shown to expand patients’ life span, NICE said.
While it’s still not clear whether the drug can help patients live longer compared with standard chemo, NICE said the drug's “cost-effectiveness estimates are within the range NICE considers to be an effective use of NHS resources." The agency didn't disclose the price of the treatment.
Just under a month ago, the U.K.'s medicines regulator awarded Xtandi with its third indication in mHSPC patients. The treatment had previously been approved for high-risk non-metastatic and metastatic castration-resistant prostate cancer.