NICE rejects clinical use of denosumab in men with metastatic prostate cancer

In the UK, the National Institute for Clinical Excellence has announced revisions to its initial, draft recommendation on the clinical use of denosumab (Xgeva®) for the treatment of people with cancer that has metastasized to the bones.

According to a media release issued by NICE on Tuesday this week, the UK’s arbitrator of evidence-based, clinical value is now making the following recommendation related to the use of denosumab:

  • The product is not recommended as an option for preventing skeletal-related events in adults with bone metastases from prostate cancer.

NICE does still recommend the use of denosumab in the treatment of women (and men) with bone metastases consequent to progressive breast cancer and for persons with bone metastases from solid tumors other than breast and prostate cancer (but only if zoledronic acid or disodium pamidronate would otherwise be prescribed for these patients).

Readers seeking detailed guidance about this most recent decision by NICE are advised to consult the related and complete documentation on the NICE web site. However, it is worth noting that NICE’s full guideline on the diagnosis and treatment of prostate cancer also does not recommend the use of bisphosphonates (e.g., zoledronic acid) as a treatment to prevent skeletal-related events. Rather, bisphosphonate use is recommended only as a method of treatment for pain relief in men with metastatic prostate cancer when other forms of treatment are failing.

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