NICE recommends coverage for cost of enzalutamide in mCRPC

Patients in the UK will be pleased to hear that the National Institute for Health and Care Excellence (NICE) has published draft guidance recommending reimbursement for enzalutamide (Xtandi) for the treatment of men with “hormone-relapsed,” metastatic prostate cancer (mCRPC) who have already been treated with at least one cycle of docetaxel-based chemotherapy. This recommendation is based on data from the Phase III AFFIRM study that led to the initial approval of enzalutamide in many countries around the world.

2 Responses

  1. Pity. It was totally useless for me. After 8 cycles, my PSA had rocketed to 550, and the tumours in my liver and bladder were continuing to grow. Ah well! Mind you, docetaxel and abiraterone had done no better!

    I’m now trying EcarboF.

  2. For others who are thinking about what they might need to do if, like David, they do not respond well to things like docetaxel-based chemo or abiraterone or enzalutamide, EcarboF refers to an aggressive form of combination chemotherapy with epirubicin + carboplatin + 5-fluorouracil that has been shown to induce remissions in “a substantial minority” of men with mCRPC (see, for example, this paper by Birtle et al.).

    Note that this form of chemotherapy does come with a significant risk for grade 3/4 hematologic and non-hematologic side effects.

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