A subgroup of patients with advanced prostate cancer could now get access to a new treatment option in England and Wales after cost regulators for the NHS issued a green light for Ferring's Firmagon (degarelix).
In final draft guidance published this morning by the National Institute for Health and Care Excellence, the drug has been recommended as an option for treating advanced hormone-dependent prostate cancer but specifically in patients with spinal metastases who present with signs or symptoms of spinal cord compression.
Firmagon, which has also won the funding nod in Scotland, is a gonadotropin-releasing hormone (GnRH) antagonist that works by suppressing luteinising hormone and thereby decreasing production of testosterone - which is necessary for prostate cancer growth - by the testicles.
Clinical tests have shown the drug can induce a rapid and sustainable drop in both testosterone and prostate specific antigen (a surrogate marker for tumour activity levels), and without an initial surge in testosterone associated with many other hormone therapies, thereby eradicating the need for short-term treatment with an anti-androgen and reducing the burden on patients.
NICE's Appraisal Committee concluded that Firmagon was non-inferior to other testosterone suppressants and acknowledged its benefit for avoiding testosterone flare, which is particularly important in people with spinal metastases who present with signs or symptoms of spinal cord compression because of the known relationship between the two.
"Men whose prostate cancer has spread to the spine are often at risk of even further damage through spinal cord compression and if left untreated this could be crippling. We fought to make this drug available and so this decision is good news which could help dramatically improve the quality of life of those men," said Mikis Euripides, Director of Policy at Prostate Cancer UK.