Prostate Scotland welcomes SMC acceptance of Olaparib as first targeted treatment in Scotland for men with BRCA 1 and 2 genes who have advanced prostate cancer
Prostate Scotland welcomes SMC acceptance of Olaparib as the first targeted treatment in Scotland for men with BRCA 1 and 2 genes who have advanced prostate cancer
Prostate Scotland, Scotland’s prostate disease charity, welcomed the decision earlier today of the Scottish Medicines Consortium to make Olaparib available on the NHS in Scotland for the treatment of metastatic castrate resistant prostate cancer for men with prostate cancer who have BRCA1 or BRCA 2 gene alterations.
‘This is a very positive and helpful decision and will potentially make a real difference for men with BRCA 1 or 2 gene alterations where their cancer has spread and they have already had novel hormone therapy. This is the first time that a treatment specially targeted at treating advanced prostate cancer in men with a BRCA 1 or 2 gene alteration has been made available in Scotland on the NHS and is therefore a significant, exciting and very welcome development’.
‘Men with BRCA 1 and 2 gene alterations are more at risk of prostate cancer than most other men and more at risk of severe disease[i], and this is first time that a treatment that is targeted to treat their prostate cancer has been made available in Scotland. The availability of Olaparib as an option for men with BRCA 1 and 2 gene repair defects and who have advanced prostate cancer is a very helpful step forward and the decision of the SMC to approve its availability on the NHS in Scotland is very much welcomed’.
Research has shown that treatment with Olaparib for men with BRCA/1 and 2 genes with metastatic castrate resistant prostate cancer (mCRPC) suggests that it can lead to a delay in metastatic cancer progression and potentially lead to an improvement in overall survival, as well as reducing pain progression by comparison to novel hormonal treatments[ii].
Approximately 10% of men with advanced prostate cancer have BRCA1/2 alterations. For these men who have castrate resistant prostate cancer there are currently few treatment options to help stop the prostate cancer progressing. Men who have BRCA 1/2 gene alterations are more at risk of prostate cancer than most other men and more at risk of significant disease[iii].
Prostate cancer is an important issue in Scotland; it is the most common cancer in men in Scotland, with a lifetime risk of one in ten. We are pleased that there have been advances in treatment over the past few years, but there is still a need for further progress.
Notes to Editors:
For further information please contact Prostate Scotland at firstname.lastname@example.org or 0131 603 8660
In many cases where the prostate cancer has not spread, men will be offered surgery or radiotherapy treatments, with a curative intent. Men where the cancer has spread will usually be offered hormone treatment/ Androgen Deprivation Treatment (ADT) to halt the growth of the cancer cells. In some men after a period of time the cancer cells may adapt to or get used to lower levels of androgen, which fuels the cancer and start to grow again – this is known as castrate resistant prostate cancer. In most men with castrate resistant prostate cancer this occurs when the cancer has spread /metastasized. Some men with prostate cancer will have BRCA 1 and 2 gene alterations.
BRCA 1/2 genes produce proteins that help repair damaged DNA. Olaparib works by inhibiting a protein called PARP, which helps cells repair themselves following DNA damage. Stopping cells repair themselves in this way does not impact on healthy cells as they have another way of repairing themselves, but cancer cells don’t have such effective repair systems so that by inhibiting PARP cancer cells can die
Prostate cancer is the most common cancer amongst men in Scotland, with a lifetime chance of one in ten men developing it[[iv]]. There were over 37,009 new registrations of men with prostate cancer between 2008 and 2018 and 9,782 deaths of men in Scotland from prostate cancer during that period.[v]. In 2018 in Scotland 4193 men were diagnosed with prostate cancer and 923 men in Scotland died from it[[vi]]. Encouragingly survival rates amongst men with prostate cancer have doubled over the past two decades with 84% of men with prostate cancer now surviving it[[vii]]. Projections by the NHS show that the diagnosis of men with prostate cancer is likely to rise by up to 35% between now and 2027[[viii]]. Nonmetastatic castrate resistant prostate cancer.
Prostate Scotland is a registered Scottish charity no SC037494. It was set up in 2006 as a Scottish charity to develop awareness of prostate disease, to support men and their families/ partners with the disease through providing advice and information and to advance treatment and research into prostate disease. Its aim is to reach out across Scotland to create greater awareness amongst men and their families/partners about prostate disease and to advance treatment. It has established an award winning website www.prostatescotland.org.uk providing a wide range of information about prostate disease and treatments, as well as providing information and advice about prostate disease to men and their families across Scotland. In 2010 the charity won a national award for its impact on community health and in 2013 and 2015 was commended in the British Medical Association Patient information Awards, and in 2017 was awarded Scottish Health Charity of the Year in the Charity Champions Awards.
[i] See Castro E, Goh C, Olmos D, et al J Clin Oncol. 2013 May 10; 31(14): 1748–1757.
[ii] See PROfound trial de Bono, Mateo, Fizazi et al (N Engl J Med 2020;382:2091-102.DOI: 10.1056/NEJMoa1911440) which showed that use of Olaparib could by comparison with a novel hormone therapy lead to increased progression free survival (the median progression-free survival was 7.4 months, as compared with 3.6 months with a novel hormone therapy). In addition to this, further research from the trial has also shown that the overall survival of men with prostate cancer and who had BRCA 1/2 and ATM gene alterations and were receiving Olaparib, median overall survival was 19.1 months, compared with 14.7 months on the control therapy – which was a novel hormone therapy (see Hussein M. et al N Engl J Med 2020;383:2345-57. DOI: 10.1056/NEJMoa2022485e
[iii] See Castro E, Goh C, Olmos D, et al J Clin Oncol. 2013 May 10; 31(14): 1748–1757. BRCA 1 and2 gene produce proteins that help repair damaged DNA. Olaparib works by inhibiting a protein called PARP, which helps cells repair themselves following DNA damage. Stopping cells repair themselves in this way does not impact on healthy cells as they have another way of repairing themselves, but cancer cells don’t have such effective repair systems so that by inhibiting PARP cancer cells can die
[iv] See Cancer Incidence in Scotland 2018 Public Health Scotland April 2020 pp21
[v] See Cancer Incidence in Scotland 2018 Public Health Scotland April 2020, Cancer mortality in Scotland 2018 Public Health Scotland October 2019
[vi] See Cancer in Scotland Public Health Scotland April 2020 and Scottish cancer registry Cancer mortality in Scotland 2018 Public Health Scotland October 2019 p8
[vii] Cancer in Scotland: ISD, NHS National Services Scotland, October 2018 pp 16-2
[viii] See Scottish Cancer Registry May 2016 and Cancer Incidence in Scotland (2014), and Information Services Division NHS National Services Scotland November 2015