# Prostate cancer drugs in England: what NICE recommends, and what it refuses

Source: https://onco.cc/terms/prostate-uk-drug-approvals/  
OnCo record `prostate-uk-drug-approvals` (Term). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Having a licence is not the same as being funded. In England several prostate cancer drugs that are approved elsewhere are not recommended by NICE, and one man in the same position in Manchester and in Boston will be offered different treatment.

## Summary

Each entry below was read from the recommendation chapter of the named NICE guidance on 25 September 2026. NICE's own wording is hormone-relapsed rather than castration-resistant, and its treatment recommendations in NG131 are written in Cambridge Prognostic Groups. The technology appraisals below are not: they carry the marketing authorisation's wording, which is still low, intermediate and high risk, so the same man is CPG 4 in the guideline and high risk in the appraisal.

Recommended.

TA1110, abiraterone (originator and generics) with androgen deprivation and prednisolone or prednisone, for newly diagnosed high-risk hormone-sensitive metastatic prostate cancer, within its marketing authorisation and with no restriction on who else it is suitable for. This review replaced TA721.

TA387, abiraterone with prednisone or prednisolone, for metastatic hormone-relapsed prostate cancer in men with no or mild symptoms after androgen deprivation has failed and before chemotherapy is indicated. TA259, the same combination after one docetaxel-containing regimen.

TA712, enzalutamide with androgen deprivation for hormone-sensitive metastatic prostate cancer. TA377, enzalutamide before chemotherapy is indicated. TA316, enzalutamide after docetaxel, with the note that use after abiraterone is not covered by that guidance.

TA741, apalutamide with androgen deprivation for hormone-sensitive metastatic prostate cancer, only if docetaxel is not suitable. TA740, apalutamide with androgen deprivation for high-risk hormone-relapsed non-metastatic prostate cancer, high risk defined as a PSA that has doubled in 10 months or less on continuous androgen deprivation.

TA1109, darolutamide with androgen deprivation for hormone-sensitive metastatic prostate cancer, only if docetaxel is not suitable, with an instruction to use the least expensive of the suitable options including apalutamide. TA903, darolutamide with androgen deprivation and docetaxel for hormone-sensitive metastatic prostate cancer. TA660, darolutamide with androgen deprivation for hormone-relapsed non-metastatic prostate cancer at high risk of metastasis.

TA995, relugolix for advanced hormone-sensitive prostate cancer, alongside radiotherapy for high-risk localised or locally advanced disease, and as neoadjuvant treatment before radiotherapy. TA404, degarelix for advanced hormone-dependent prostate cancer, only in people with spinal metastases and only at the discounted drug cost available to the NHS in June 2016.

TA101, docetaxel for hormone-refractory metastatic prostate cancer only if the Karnofsky performance-status score is 60 percent or more, stopping after up to 10 cycles, on severe adverse events or on progression, with repeat courses not recommended. TA391, cabazitaxel with prednisone or prednisolone after docetaxel, only with ECOG performance status 0 or 1, at least 225 mg/m2 of prior docetaxel, and stopping at progression or after 10 cycles.

TA412, radium-223 dichloride for hormone-relapsed prostate cancer with symptomatic bone metastases and no known visceral metastases, only after docetaxel or where docetaxel is contraindicated or unsuitable.

TA887, olaparib for hormone-relapsed metastatic prostate cancer with BRCA1 or BRCA2 mutations that has progressed after a newer hormonal treatment. TA951, olaparib with abiraterone and prednisone or prednisolone for untreated hormone-relapsed metastatic prostate cancer in adults who cannot have or do not want chemotherapy. TA1130, talazoparib with enzalutamide for untreated hormone-relapsed metastatic prostate cancer, only when chemotherapy is not clinically indicated and abiraterone with prednisolone is not tolerated or is precluded.

Not recommended, or unavailable.

TA930, lutetium-177 vipivotide tetraxetan, not recommended within its marketing authorisation for PSMA-positive hormone-relapsed metastatic prostate cancer after taxane-based chemotherapy and an anti-androgen, or when taxanes are medically unsuitable. The committee noted that no evidence was submitted comparing it with radium-223, so that comparison could not be considered. This is the largest gap between label and funding in the disease.

TA580, enzalutamide not recommended for high-risk hormone-relapsed non-metastatic prostate cancer. The committee accepted that it extends the time until the cancer spreads and found no evidence that it extends life, with cost-effectiveness estimates outside the usual range. Apalutamide and darolutamide are recommended in the same population, so the refusal is about this drug's case, not the class.

TA546, padeliporfin not recommended for untreated, unilateral, low-risk prostate cancer. The committee's reasoning is the same argument NICE makes for active surveillance: long-term studies show men with low-risk disease live as long under active surveillance, and radical and focal therapies carry long-term side effects.

TA332, sipuleucel-T: guidance withdrawn because the marketing authorisation was withdrawn.

TA1032, niraparib with abiraterone acetate and prednisone for untreated hormone-relapsed metastatic prostate cancer: terminated appraisal, 22 January 2025. Johnson and Johnson Innovative Medicine did not provide an evidence submission, so NICE was unable to make a recommendation. NICE will review the decision if the company submits.

## Fields

- Kind: Term
- Status: established
- Last checked: 2026-09-25
- Also known as: NICE prostate cancer appraisals; prostate cancer drug funding England; prostate cancer NICE numbers

## Sources

- NICE TA1110: abiraterone (originator and generics) for newly diagnosed high-risk hormone-sensitive metastatic prostate cancer: https://www.nice.org.uk/guidance/ta1110
- NICE TA930: lutetium-177 vipivotide tetraxetan for PSMA-positive hormone-relapsed metastatic prostate cancer after 2 or more treatments, not recommended: https://www.nice.org.uk/guidance/ta930
- NICE TA580: enzalutamide for hormone-relapsed non-metastatic prostate cancer, not recommended: https://www.nice.org.uk/guidance/ta580
- NICE TA546: padeliporfin for untreated localised prostate cancer, not recommended: https://www.nice.org.uk/guidance/ta546
- NICE NG131: prostate cancer: diagnosis and management: https://www.nice.org.uk/guidance/ng131

## Connected records

- cancers: [Metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-mcrpc/), [Metastatic hormone-sensitive prostate cancer](https://onco.cc/cancers/prostate-mhspc/), [Non-metastatic castration-resistant prostate cancer](https://onco.cc/cancers/prostate-nmcrpc/), [Prostate cancer](https://onco.cc/cancers/prostate/)
- drugs: [Abiraterone acetate](https://onco.cc/drugs/abiraterone/), [Apalutamide](https://onco.cc/drugs/apalutamide/), [Cabazitaxel](https://onco.cc/drugs/cabazitaxel/), [Darolutamide](https://onco.cc/drugs/darolutamide/), [Degarelix](https://onco.cc/drugs/degarelix/), [Docetaxel](https://onco.cc/drugs/docetaxel/), [Enzalutamide](https://onco.cc/drugs/enzalutamide/), [Lutetium-177 vipivotide tetraxetan](https://onco.cc/drugs/pluvicto/), [Niraparib](https://onco.cc/drugs/niraparib/), [Olaparib](https://onco.cc/drugs/olaparib/), [Padeliporfin](https://onco.cc/drugs/padeliporfin/), [Radium-223 dichloride](https://onco.cc/drugs/radium-223/), [Relugolix](https://onco.cc/drugs/relugolix/), [Sipuleucel-T](https://onco.cc/drugs/sipuleucel-t/), [Talazoparib](https://onco.cc/drugs/talazoparib/)
- terms: [Androgen deprivation therapy (ADT)](https://onco.cc/terms/adt/), [Androgen receptor pathway inhibitor (ARPI)](https://onco.cc/terms/arpi/), [Castration-resistant prostate cancer (CRPC)](https://onco.cc/terms/castration-resistance/)
- trials: [A Study of Apalutamide (ARN-509) in Men With Non-Metastatic Castration-Resistant Prostate Cancer](https://onco.cc/trials/nct01946204/), [ALSYMPCA](https://onco.cc/trials/alsympca/), [ARAMIS](https://onco.cc/trials/aramis/), [ARANOTE](https://onco.cc/trials/aranote/), [ARASENS](https://onco.cc/trials/arasens/), [ARCHES](https://onco.cc/trials/arches/), [EMBARK](https://onco.cc/trials/embark/), [ENZAMET](https://onco.cc/trials/enzamet/), [LATITUDE](https://onco.cc/trials/latitude/), [MAGNITUDE](https://onco.cc/trials/magnitude/), [PROfound](https://onco.cc/trials/profound/), [PROpel](https://onco.cc/trials/propel/), [PROSPER](https://onco.cc/trials/prosper/), [TALAPRO-2](https://onco.cc/trials/talapro-2/), [VISION](https://onco.cc/trials/vision/)

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