You may hear stories in the news about new treatments for prostate cancer. New treatments you may have heard about include:

Cabazitaxel (Jevtana®). A new type of chemotherapy treatment for men with advanced prostate cancer that has stopped responding to hormone therapy and the chemotherapy medicine docetaxel (Taxotere®). Cabazitaxel is licensed for use in the UK but is not yet widely available on the NHS.

Enzalutamide (Xtandi®), also called MDV3100. A new type of hormone therapy for men with advanced prostate cancer that is no longer responding to hormone therapy or chemotherapy.

Radium-233 (Xofigo®): A new drug for men with cancer that has spread to the bones and has stopped responding to hormone therapy. Radium-223 is licensed for use in the UK, but it’s not widely available on the NHS.

Abiraterone (Zytiga®): A new type of hormone therapy for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to other hormone therapy and chemotherapy treatments. Abiraterone has now been approved for use in these men in UK. 

Abiraterone has also been licensed for men whose prostate cancer has stopped responding to other hormone therapy but have not yet had chemotherapy. However, it is not widely available for these men on the NHS. Read more about abiraterone.

 

 

What is cabazitaxel (Jevtana ®)?

Cabazitaxel is a new type of chemotherapy treatment for men with prostate cancer that has spread to other parts of the body (advanced prostate cancer) and has stopped responding to hormone therapy and the chemotherapy medicine docetaxel (Taxotere®). It is used to help control symptoms and not to cure prostate cancer.

For more information on cabazitaxel, speak to your specialist team or call our Specialist Nurses.

How does cabazitaxel treat prostate cancer?

Cabazitaxel is a chemotherapy treatment. Chemotherapy uses anti-cancer drugs to kill cancer cells. It's used to help control symptoms and not to cure prostate cancer.

Cabazitaxel is given through a drip (intravenous infusion). This usually involves running the medicine through a thin tube into a vein.

In a recent clinical trial, men who were given cabazitaxel lived about two and a half months longer than men who were given a different type of chemotherapy.

Who can have cabazitaxel?

Cabazitaxel is suitable for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to hormone therapy and the chemotherapy medicine docetaxel (Taxotere®).

Cabazitaxel is licensed for use in the UK, but it's not yet widely available on the NHS. This is because the National Institute for Health and Care Excellence (NICE) and the Scottish Medicines Consortium (SMC) have decided not to fund it. You can read our comment on this decision on our research news page.

If your doctor tells you that cabazitaxel is suitable for you and you decide you want to have it, but your local healthcare provider does not provide it free on the NHS, you may still be able to get treatment. It’s currently available in England, through the Cancer Drugs Fund, for men who have already had docetaxel chemotherapy. In the rest of the UK it may be possible for your doctor to make a treatment request to your local health board. You can read our page Getting new medicines for more information on how to get access to medicines.

What is enzalutamide (Xtandi®)?

Enzalutamide is a new type of hormone therapy for men whose prostate cancer has spread to other parts of the body (advanced prostate cancer) and has stopped responding to other hormone therapy and chemotherapy treatments.

In England and Wales, NICE approved enzalutamide for men who have already had the chemotherapy drug docetaxel, in July 2014. This means that enzalutamide should be available for these men on the NHS within three months, although it might be available sooner in some areas.

NICE have said that there's no reason for men who have already had abiraterone not to have enzalutamide. But they haven't said that it should be available to these men. NHS England - who are responsible for paying for these drugs in England - have said that they won't pay for enzalutamide for men who have already had abiraterone. We don't yet know whether the Cancer Drugs Fund will pay for these men to have enzalutamide. This means that at the moment, if you live in England and have already had abiraterone, you won't be able to get enzalutamide on the NHS. If you've had abiraterone and have problems getting enzalutamide, let us know.

We are waiting to hear whether NHS Wales will pay for men in Wales who have already had abiraterone to have enzalutamide.

NICE's decisions are normally accepted in Northern Ireland after local review. Until then, it may be possible for your doctor to make a treatment request to your local health board.

In Scotland, the Scottish Medicines Consortium (SMC) approved enzalutamide in November 2013, so it's now available on the NHS in Scotland.

Read about our campaign to make enzalutamide available to more men with advanced prostate cancer.

How does enzalutamide treat prostate cancer?

Enzalutamide is taken as a tablet and works by stopping the hormone testosterone from reaching the prostate cancer cells. Without testosterone, the cancer cells are not able to grow, wherever they are in the body.

In a recent clinical trial, men who received enzalutamide lived for about four months longer than those who were given a placebo.

For more information on enzalutamide, speak to your doctor or nurse, or call our Specialist Nurses.

What is radium-223 (Xofigo®)?

Radium-233 is a new drug for men with prostate cancer that has spread to the bones and has stopped responding to hormone therapy.

Radium-223 is licensed for use in the UK, but it’s not available on the NHS. It is available in England through the Cancer Drugs Fund. If you live in Scotland, Wales or Northern Ireland, your doctor may be able to apply for you to get it if they think it’s suitable for you.

How does radium-223 treat prostate cancer?

Radium-223 is a radioactive substance which is injected into a vein. It travels around the body in the blood and is taken up by bones that have been damaged by prostate cancer. It kills the prostate cancer cells in the bones, but doesn’t damage many surrounding healthy cells.

Radium-223 improves the symptoms of advanced prostate cancer that affect the bones, such as pain – and so can help improve your daily life. It may also help men live longer. In a recent clinical trial, men on radium-223 lived on average 4 months longer than men on placebo. A placebo is a dummy treatment – in this case, an injection with a salt water solution.

What are the side effects of radium-223?

Radium-223 does not cause much damage to the surrounding healthy cells, so it doesn’t usually cause side effects. If you do get side effects they may include feeling and being sick (nausea and vomiting), diarrhoea, and low levels of blood cells called platelets, which means you might bleed more easily.

For more information about radium-223 speak to your doctor or nurse, or call our Specialist Nurses.

References

  • Full list of references used to produce this page  

    "In a recent clinical trial, men who were given cabazitaxel lived about two and a half months longer than men who were given a different type of chemotherapy."

    This comes from:

    De Bono JS, Oudard S, Ozguroglu M, Hansen S, Machiels JP, Kocak I et al. Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial. The Lancet 201;376:1147- 1154.

    "In a recent clinical trial, men who received abiraterone lived about four months longer than those who were given a placebo."

    This comes from:

    de Bono JS, Logothetis CJ, Molina A, Fizazi K, North S, Chu L et al.. Abiraterone and increased survival in metastatic prostate cancer. N Engl J Med. 2011;364:1995-2005.

    "In a recent clinical trial, men who received enzalutamide lived for about four months longer than those who were given a placebo."

    This comes from:

    Scher HI, Fizazi K, Saad F et al. Effect of MDV3100, an androgen receptor signaling inhibitor (ARSI), on overall survival in patients with prostate cancer postdocetaxel: Results from the phase III AFFIRM study. Presented at ACSO 2012 Genitourinary Cancers Symposium.

    Radium-223 is licensed for use in the UK.

    This comes from:
    UK Medicines Information. New Drugs online. Available at: http://www.ukmi.nhs.uk/applications/ndo/record_view_open.asp?newDrugID=4850 (Accessed February 2014)

    Available in England through the Cancer Drugs Fund.

    This comes from:
    National Cancer Drugs Fund (Update 3 February 2014). Available at: http://www.england.nhs.uk/wp-content/uploads/2014/02/ncdf-list-feb14.pdf

    "In a recent clinical trial, men on radium-223 lived on average 4 months longer than men on placebo."

    This comes from:
    Parker C, Nilsson S, Heinrich D, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013 Jul 18;369(3):213-23.

    Side effects of radium-223.

    This comes from:
    Parker C, Nilsson S, Heinrich D, et al. Alpha emitter radium-223 and survival in metastatic prostate cancer. N Engl J Med. 2013 Jul 18;369(3):213-23.