Enzalutamide for treating hormone-sensitive metastatic prostate cancer

1.1 Enzalutamide plus androgen deprivation therapy (ADT) is recommended, within its marketing authorisation, as an option for treating hormone-sensitive metastatic prostate cancer in adults. It is only recommended if the company provides enzalutamide according to the agreed commercial arrangement.

Why the committee made these recommendations

Current treatment for hormone-sensitive metastatic prostate cancer in the NHS is ADT alone, or docetaxel plus prednisolone or prednisone (from now, docetaxel) plus ADT. Enzalutamide plus ADT would offer another option for people with hormone-sensitive metastatic prostate cancer, especially for people who cannot have docetaxel. It is taken by mouth so is more convenient than docetaxel, which is an intravenous treatment.

Trial results suggest that, compared with ADT alone, enzalutamide plus ADT increases the time until the cancer progresses and how long people live. Also, an indirect comparison suggests that, compared with docetaxel plus ADT, enzalutamide plus ADT increases the time until the cancer progresses. But, it is unclear whether there is a difference between the 2 treatments in the length of time people live.

The cost-effectiveness estimates are within the range NICE considers an acceptable use of NHS resources. Therefore, enzalutamide plus ADT is recommended for hormone-sensitive metastatic prostate cancer.