AstraZeneca (AZ) and Merck’s – known as MSD outside the US and Canada – Lynparza (olaparib) has been recommended by the National Institute for Health and Care Excellence (NICE) as part of a combination treatment for patients with an advanced form of prostate cancer, regardless of biomarker status.
The PARP inhibitor has been specifically recommended for NHS use alongside anti-androgen therapy Zytiga (abiraterone) and prednisone or prednisolone in adults with untreated hormone-relapsed metastatic prostate cancer who cannot have or do not want chemotherapy.
More than 52,000 men are diagnosed with prostate cancer each year in the UK and up to 20% of those with advanced cases will develop castration-resistant prostate cancer (CRPC) within five years.
CRPC at an advanced or metastasised stage (mCRPC) is typically hard to treat and has a poor prognosis, with half of mCRPC patients only ever receiving one line of therapy.
Lynparza, given as a tablet, works by inhibiting the PARP enzyme, which helps cells repair damaged DNA. By blocking this enzyme, PARP inhibitors prevent the DNA of cancer cells from being repaired, preventing them from growing and spreading.
“Critically, this is the first time that patients with this form of prostate cancer will be able to access a PARP inhibitor without the need for a specific biomarker test,” said Tom Keith-Roach, president, AZ UK.
The final draft guidance from NICE was supported by results from the late-stage PROpel trial, which showed that the Lynparza combination therapy reduced the risk of disease progression or death by 34%.
David Long, head of oncology at MSD UK, said: “We are delighted that NICE has recognised the clinical and economic benefits of [Lynparza] in combination with [Zytiga] and prednisone or prednisolone as a first-line, targeted treatment for mCRPC.
“This type of prostate cancer has unacceptable survival rates, and [the] NICE recommendation marks a vital step forward in changing the narrative for these patients.”
The decision from NICE comes less than two weeks after the agency recommended Lynparza alongside Genentech’s Avastin (bevacizumab) as a maintenance treatment in adults with advanced epithelial ovarian, fallopian tube or primary peritoneal cancer, whose disease is associated with homologous recombination deficiency-positive status.