Thousands could benefit from new take-at-home treatment for advanced prostate cancer
NICE recommends life-extending daily pill which offers hope for people who cannot take standard treatment.
Thousands of people living with advanced prostate cancer will have access to a life-extending new treatment that can be taken at home from today (Friday, 23 January).
NICE has recommended talazoparib (also known as Talzenna, made by Pfizer), taken alongside enzalutamide, for adults with prostate cancer that has spread.
The treatment is recommended for people where chemotherapy is not suitable and who cannot tolerate or take abiraterone plus prednisolone, one of the current standard treatments.
The recommendation marks an important step forward in giving people more treatment options – especially those who cannot undergo chemotherapy. The once-daily pill can be taken at home so also offers greater convenience and flexibility for patients while reducing pressure on NHS services.
Talazoparib blocks an enzyme that repairs damaged DNA in certain cancer cells. Without this repair mechanism, the cancer cells die.
Around 2,400 people in England are eligible for the drug.
Clinical trials found that people taking talazoparib with enzalutamide lived significantly longer and had more time before their cancer got worse. Overall survival was 45.8 months compared with 37 months for those on enzalutamide alone – an increase of nearly nine months. The time people live without their cancer getting worse also increased: 33.1 months compared with 19.5 months – an increase of over a year.
We are continuing to focus on what matters most to people by recommending this effective treatment that can make a huge difference to the lives of people with advanced prostate cancer.
Talazoparib plus enzalutamide can be taken at home, so provides a convenient and flexible treatment option for people who can't have chemotherapy and are not able to take other medicines so have limited treatment options.
This is the third new treatment for metastatic prostate cancer recommended by NICE in recent months, following darolutamide and abiraterone for prostate cancer that has spread but still relies on male hormones (androgens), making it treatable with hormone therapy to lower testosterone.
Amy Rylance, assistant director of Health Improvement at Prostate Cancer UK, said: "When hormone therapy stops working for a man with advanced prostate cancer, who is unable to have chemotherapy, it can be hugely distressing. Their treatment options become more limited, and they face a lot of uncertainty. That's why the fact this treatment is now approved is so exciting.
"For these men, having talazoparib approved is a real lifeline, and research shows that men who receive talazoparib alongside enzalutamide get almost nine months more of life with their loved ones than men just on enzalutamide."
We know that for men with some genetic variations, like BRCA and HRR, the treatment can be even more effective. Prostate Cancer UK worked with NICE to make this treatment available, and I'm so pleased men will now be able to access it and take it in the comfort of their own homes.
A confidential commercial arrangement is in place to provide talazoparib to the NHS at a discounted price.
Prostate cancer is one of the most common cancers in the UK. In 2019–2020, nearly 46,000 new cases were diagnosed in England and Wales, with 13% being where it has spread (metastatic) at diagnosis. Around 12,000 deaths each year are attributed to prostate cancer.
The treatment is available in the NHS from today.
Read the full final draft guidance on talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer.