New NHS Treatment Option for Advanced Prostate Cancer

Men in England and Wales with advanced prostate cancer that has spread beyond the prostate — known as metastatic hormone-sensitive prostate cancer (mHSPC) — now have access to a new treatment on the NHS. NICE has recommended the medicine darolutamide (Nubeqa®), used alongside standard hormone therapy, for men who are not suitable for chemotherapy. The decision follows an announcement in June of this year that the treatment would be made available alongside chemotherapy.

When prostate cancer becomes metastatic, it means the cancer has travelled to other areas of the body such as lymph nodes or bones. At this stage, treatment aims to keep the cancer under control for as long as possible, delay symptoms, and protect quality of life. Even when the cancer has spread, many men still respond well to treatments that reduce testosterone — because testosterone acts as a fuel for prostate cancer to grow. These treatments are called androgen deprivation therapy (ADT). 

Darolutamide works by blocking testosterone from reaching cancer cells. Although ADT lowers testosterone levels in the body, small amounts can still get through. By preventing testosterone from “switching on” prostate cancer cells, darolutamide helps slow or stop the cancer continuing to grow. It is taken as tablets at home. 

This NHS decision is based on results from a major international study called the ARANOTE trial. The study compared men receiving darolutamide alongside hormone therapy with men receiving hormone therapy alone. Those given darolutamide lived significantly longer before their cancer worsened — the risk of the cancer progressing or the patient dying during the study period was reduced by 46 per cent compared with hormone therapy alone. Encouragingly, men taking darolutamide also maintained their quality of life for longer.  

NHS organisations in England and Wales must now make the technology available to patients by 22 January at the latest. If you or someone close to you has been diagnosed with advanced prostate cancer, your healthcare team can talk through all available treatments and whether this newly approved option might be suitable for you.