With the astonishing success of the STAMPEDE trial now officially published in a peer-reviewed medical journal, we call for upfront docetaxel treatment for men with advanced prostate cancer to be adopted across NHS England without further delay.
The much anticipated official results of the docetaxel arm of the STAMPEDE trial were published today in the Lancet, a leading medical journal. The trial reported an almost unprecedented survival benefit for men newly diagnosed with advanced prostate cancer, when they were given docetaxel chemotherapy as a first line treatment alongside hormone therapy.
On average, men receiving this treatment live 15 months longer than those on the traditional treatment pathway of hormone therapy followed by docetaxel chemotherapy once the hormone treatment stops working.
This survival benefit, while still extremely impressive, is lower than the previously stated 22 months for men with metastatic disease. This is because in the time between the results being announced and being peer-reviewed and published, ten more men in each of the control and treatment arms of the study had died. When their data was incorporated, the average survival benefit had to be revised down to 15 months.
It’s been a long and frustrating wait for the 'official seal of approval' that publication in an internationally peer-reviewed journal represents. But now the final obstacle to universal access has been removed, we expect this drug to be made available to all the men who need it as soon as humanly possible – if not sooner.
Despite the wait, and the frustrations it’s unleashed, peer review is not a needlessly bureaucratic process that can be selectively dispensed with. It's an essential measure to ensure that scientific evidence is as valid and robust as it is presented to be.
We’re delighted that NHS England has ensured an accelerated review of the evidence, and that we’ve been invited to support the development of a commissioning policy for upfront docetaxel. We urge everyone involved to maintain this speed and sense of urgency. This treatment will prolong men’s lives and every second really does count.
Moreover, we strongly urge all local Clinical Commissioning Groups (CCG) to make access to upfront docetaxel available for eligible men in the UK their top priority. Now that the results are published, and a commissioning policy near to completion, there is no acceptable excuse for CCGs to deny men this treatment any longer.
Angela Culhane, Chief Executive of Prostate Cancer UK said: “Since the first results of STAMPEDE were announced we’ve been doing everything we can to convince decision makers that giving earlier access to docetaxel is a no-brainer which could provide unprecedented benefits for many men at minimal cost to the NHS. Whilst we respect NHS England’s need to check that the results stand up to scrutiny, there is absolutely no excuse for delay now that they are in the Lancet in black and white.
“Following our efforts, preparations are already well underway to get the commissioning policy revised. This is a positive result that means men will be accessing the treatment much sooner after publication than was originally going to be the case. However we will continue applying pressure until we know that men are actually receiving this treatment in the clinic and reaping the benefits. For every month that this drug isn‘t available, at least 500 men lose out on a potential extra year of life – it’s unacceptable to continue to deny men these benefits simply because of bureaucratic obstacles.”