NICE does not recommend Zytiga (abiraterone) for treatment of prostate cancer before chemotherapy- Janssen

In final draft guidance published by The National Institute for Health and Care Excellence (NICE) has not recommended Zytiga (abiraterone) from Janssen, for prostate cancer in people who received hormone therapy (androgen deprivation) but whose disease has spread, who have few symptoms and when chemotherapy has not yet have been given. Prostate cancer that has spread is first treated hormonally – with androgen deprivation therapy. When this treatment does not work any longer, docetaxel containing chemotherapy can be given. Abiraterone is a hormone therapy, and unlike chemotherapy which kills the cancerous cells, it stops more testosterone from reaching the prostate gland and thereby stifles the tumour.

Abiraterone has previously been recommended by NICE for treatment after docetaxel containing chemotherapy. The current appraisal is considered the use of abiraterone before chemotherapy.The clinical evidence submitted by the manufacturer came from one trial (COU-AA-302). Although the results indicated that, when compared with placebo, abiraterone could delay the progression of the disease, it was not clear how much abiraterone actually extended life. A 20% discount offered by Janssen did not affect the decision.