UK’s NICE Advises Against NHS Use of Lynparza for Prostate Cancer
{Olaparib, sold under the brand name Lynparza, is a medication for the maintenance treatment of BRCA-mutated advanced ovarian cancer in adults. It is a PARP inhibitor, inhibiting poly ADP ribose polymerase (PARP), an enzyme involved in DNA repair. It acts against cancers in people with hereditary BRCA1 or BRCA2 mutations, which include some ovarian, breast, and prostate cancers.} [1]
"AstraZeneca’s drug Lynparza was rejected in a draft guidance by the UK’s National Institute for Health and Care Excellence (NICE) as a treatment for prostate cancer for use by the National Health Service.
Lynparza is aimed at adults whose BRCA-positive prostate cancer has progressed after use of the hormone-based chemotherapy drug abiraterone or treatment with the nonsteroidal antiandrogen enzalutamide.
Though clinical trial evidence showed that study subjects taking Lynparza had improved progression-free survival and overall survival, NICE said that there is no direct comparison of Lynparza to the current standard of care for metastatic prostate cancer, which includes chemotherapy drugs docetaxel, cabazitaxel or the radiation drug radium-223.
The draft guidance is open for comment until March 26, after which NICE will make its final recommendation."
A bad ending to the week for AstraZeneca, what with:
"Denmark and Norway suspend AstraZeneca covid vaccine over blot clot concerns, even as European regulator maintains it is safe" [Washington Post]
Wonder if this has anything to do with whatever arrangement has been made between NHS and AstraZeneca on the price of the drug? The questioned "cost-effectiveness" of a drug must come under some pressure when the drug is quite costly.
New drugs (which are always priced high) are routinely rejected by NICE. I remember Velcade (Bortezomib), a game changer in multiple myeloma, eventually being accepted*** in time to give my sister some extra years. 3-year mortality used to be extremely high in MM.
Can't be easy for the people at NICE to be playing hardball with BigPharma while being pressured by patients, families, etc.
Here's something from Apr 8, 2019:
"In a final appraisal released Monday, the National Institute for Health and Care Excellence (NICE) chose not to recommend Xtandi for treatment of hormone-relapsed, non-metastatic prostate cancer, citing unconvincing data from a recent trial coined PROSPER.
“The committee concluded that the latest evidence available did not show a survival benefit with enzalutamide (Xtandi) relative to placebo for hormone-relapsed non-metastatic prostate cancer,” the appraisal said."
My translation: 'Too expensive". I wonder if the treatment protocol now include a placebo.
-Patrick
*** "In the UK, NICE initially recommended against Velcade in October 2006, due to its cost of about GB£18,000 per person, and because studies reviewed by NICE reported that it could only extend the life expectancy by an average of six months over standard treatment. However, the company later proposed a performance-linked cost reduction for multiple myeloma, and this was accepted." [Wiki]
Perhaps NICE should just leave off the "E" since "excellence" in many forms is rarely inexpensive until it is subjected to competition, patent expiration, economies of scale, etc.
The new acronym, NIC, would then be more appropriately short for "NICkel and dime."
On the other hand, being cheap is a primary reason for renewed research and interest in (transdermal) estrogen as a form of ADT. So there's that, too.
Comparing Immunotherapy to Androgen Deprivation is Apples to Oranges! They do two completely different things... I fail to understand why it is grouped together when considering OS numbers! For instance, here in the U.S. the FDA approval is only for patients who become CRPC, when the Olaparib has nothing to do with castrate resistance, it is here that I fail to understand why it is associated with progressing to this advanced stage in order to use the drug to fix dna function.
Ehhhhh, just sounding off!
And oh, yes, definitely the cost is a main factor, I'm sure even for insurance approval when there are much cheaper, but less effective drugs available
As a very grateful beneficiary of NHS medicine, I am pleased that they do not jump on every expensive bandwagon big pharma wish to foist on us. NICE keeps them real, and ensures that the UK has one of the most cost effective and comprehensive health systems in the world. This ruling does not prevent an individual buying his own, just as our American friends can. There is quite a large private health sector in the UK. However, observers might have noted that the Duke of Edinburgh recently entered a private hospital for a few days until something needed doing. He was transferred to the NHS for surgery. Boris was treated under the NHS for COVID. There is something to be taken on board here. If you have a life threatening condition there is no better place to be.
I read a little bit about the ADP ribose studies. Just wanted to see if ADP ribose is related in anyway to D-Ribose? I want to start taking D-Ribose a couple times a day to counter my loss of ATP production, caused by Levaquin poisoning. Naturally, I don't want to take D-Ribose if it's going to accelerated/stimulate the cancer.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Men With BRCA-2 Mutation-How are you Treating/Doing?
Fasting nicely explained
Bipolar Androgen Therapy (BAT) update (with olaparib)
Does insulin play a role in prostate cancer?
Clinical trial / study: BRCA mutations
