Reason for request
Inclusion
First assessment.
Key points
Favourable opinion for reimbursement in the “treatment of adult patients with advanced hormone-sensitive prostate cancer”.
Role in the care pathway?
ORGOVYX (relugolix) is an additional therapeutic option in the first-line treatment of advanced hormone-sensitive prostate cancer, in the same way as the other GnRH agonist or antagonist medicinal products already available.
Clinical Benefit
| Substantial |
The clinical benefit of ORGOVYX (relugolix) 120 mg film-coated tablets is substantial in the MA indication.
|
Clinical Added Value
| no clinical added value |
Considering:
- demonstration of a non-inferiority of relugolix compared to leuprorelin:
- on an acceptable endpoint, which is the achievement and maintenance of androgen suppression;
- in a study context favourable to treatment compliance;
- the safety profile, which is deemed to be acceptable versus clinically relevant comparators;
and despite:
- the open-label nature of the HERO study leading to an assessment and follow-up bias, whereas double-blinding was feasible;
- the inclusion of a heterogeneous population with, in particular, more than a third of the patients included not corresponding to the scope of the MA (28.0% localised form and 9.8% not
classifiable) i.e. advanced hormone-sensitive prostate cancer, grouping together metastatic and locally advanced stages;
- the absence of an efficacy analysis performed in the study subpopulation corresponding to the MA, i.e. patients with advanced hormone-sensitive prostate cancer;
- the profile of the patients with a metastatic form included in the HERO study, which does not correspond to those immediately treated in current clinical practice with the combination of a GnRH agonist or antagonist (androgen deprivation) with second-generation hormone therapy (only enzalutamide could be added during the study in the event of PSA progression);
the Committee deems that ORGOVYX (relugolix) 120 mg film-coated tablets provide no clinical added value (CAV V) in the current care pathway.
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