Relugolix is recommended, within its marketing authorisation, as an option for treating prostate cancer in adults:
with advanced hormone-sensitive prostate cancer
alongside radiotherapy for high-risk localised or locally advanced hormone-sensitive prostate cancer
as neoadjuvant treatment before radiotherapy for high-risk localised or locally advanced hormone-sensitive prostate cancer.
Why the committee made this recommendation
Hormone-sensitive (also called hormone-dependent) prostate cancer is usually treated with androgen deprivation therapy (ADT) such as leuprolide. This may be used alone, or with chemotherapy, radiotherapy or androgen receptor inhibitors. Relugolix is an ADT.
Clinical trial evidence suggests that relugolix is better at reducing testosterone to levels that stop cancer growth in the long term, and reduces the risk of serious cardiovascular events, compared with leuprolide. An indirect treatment comparison suggests that relugolix works as well as other ADTs, but this is uncertain.
The cost-effectiveness estimates are within the range that NICE considers an acceptable use of NHS resources. So, relugolix is recommended.