Experts are demanding an end to an NHS postcode lottery for a life-saving prostate cancer drug, after a landmark study found a test can pinpoint the men who need it most. The hormone therapy, abiraterone, is available through the health service in Scotland and Wales for men with high-risk prostate cancer that has not yet spread. But the NHS in England does not cover the £77-a-month treatment.
Now, a study has found that artificial intelligence can identify the men who will benefit most — slashing the number who would need to be treated from around 8,400 to just over 2,000. Professor Nick James, a prostate and bladder cancer researcher at The ICR and consultant clinical oncologist at The Royal Marsden NHS Foundation Trust, said: “I truly hope that this new research — showing precisely who needs the drug to live well for longer — will lead to NHS England reviewing their decision.”
Patient Giles Turner is among those unable to access abiraterone on the NHS after he was diagnosed with prostate cancer in March 2023.
He chose to pay for the treatment — which has cost him a staggering £20,000 so far. Giles, 64, said: “This is great research and adds even more reason for NHS England to start funding this treatment now.
“I find it very difficult to come to terms with having to pay for this treatment whereas if I was with the NHS in Scotland or Wales I would not.”
The retired banker, of Brighton, said thousands of men in England who could not afford the “cheap, life-saving and cost-saving drug” were missing out. He added: “Action must be taken by NHS England and Department of Health and Social Care right now.”
Scientists at the The Institute of Cancer Research in London and University College London used the AI test to analyse biopsy images from more than 1,000 patients who took part in a trial of the drug.
Developed by Artera Inc., the AI searches for features that are invisible to the human eye. Men were given a score depending on whether their disease was fuelled by male hormones known as androgens.
The analysis found that one in four men had tumours described as “biomarker-positive”. Their risk of death after five years was cut from 17% to 9% if they took the drug.
Meanwhile, men classed as “biomarker-negative” saw their death risk cut from 7% to 4% — a difference that was not clinically significant.
Men in the latter group could therefore have been given standard therapy and spared the side effects of unnecessary hormone treatment, researchers said.
The breakthrough means use of the drug could be targeted at those men who are most likely to benefit, vastly reducing the potential cost, experts added.
The results will be presented at the American Society of Clinical Oncology’s Annual Meeting which begins in Chicago on Friday.
Prof James said abiraterone could deliver “spectacular results” for some patients. Calling for an end to the postcode lottery, he added: “Since the patent expired in 2022, abiraterone costs just £77 per pack — compared with the thousands of pounds that new drugs cost.
“Previous research by my team has shown that preventing cancer relapses for these men would save more money than the drug costs to purchase.”
Dr Matthew Hobbs, director of research at Prostate Cancer UK, said his charity had been calling for the drug’s use on the NHS to be expanded for over two years. He added: “These exciting results suggest a way to make this an even more cost-effective approach.
“We therefore echo the researchers’ urgent call for abiraterone to be made available to those men whose lives it can save — men who, thanks to this research, we can now identify more precisely than ever before.”
ICR chief executive Professor Kristian Helin said: “Abiraterone has been a game changer for treatment of prostate cancer, and I’m proud of the ICR’s role in discovering and testing this drug which has extended the lives of so many men.
“Alongside our mission to find smarter, kinder treatments, we must ensure we are matching the right drugs to the right patients.
“This research, using artificial intelligence, provides an innovative route to testing prostate cancer patients to determine their treatment. I hope that this can be implemented so that all men with prostate cancer who will benefit from abiraterone can do so.”