The Institute for Clinical and Economic Review (ICER) on Friday released an Evidence Report assessing the comparative clinical effectiveness and value of antiandrogen therapies for the treatment of nonmetastatic castration-resistant prostate cancer. The report focuses on three antiandrogen therapies: abiraterone acetate (Zytiga; Janssen Biotech, Inc.; a separate formulation [Yonsa; Sun Pharma] was not evaluated), enzalutamide (Xtandi; Astellas Pharma, Inc.), and apalutamide (Erleada; Janssen Biotech, Inc.).
“While data on overall survival improvements are still immature, treating men with high-risk castration-resistant prostate cancer with antiandrogen therapies earlier, before metastatic disease is detected by conventional imaging, appears to improve outcomes,” noted David Rind, MD, MSc, ICER’s Chief Medical Officer. “Unfortunately, the lack of long-term survival data and the absence of head-to-head trials limits our ability to compare the effectiveness of enzalutamide with that of the newer drug apalutamide. For abiraterone, we have less certainty in its added benefits when used before cancer progression is detected, making it even more difficult to judge how its effectiveness matches up with the other treatment options. However, for all three drugs, while there are additional costs associated with earlier treatment, those costs appear to be aligned with the clinical benefits patients receive.”
ICER did not assess the therapies’ value for treating later stage disease.
This Evidence Report will be the subject of a Sept. 13 public meeting of the Midwest Comparative Effectiveness Public Advisory Council (Midwest CEPAC) in Chicago, Illinois. The Midwest CEPAC is one of ICER’s three independent evidence appraisal committees comprising medical evidence experts, practicing clinicians, methodologists, and leaders in patient engagement and advocacy.