NICE proposes to recommend a new treatment for some people with advanced kidney cancer

NICE, the healthcare guidance body, has issued new final draft guidance recommending axitinib (Inlyta, Pfizer), for advanced kidney cancer [1].

Renal cell carcinoma is a kidney cancer that starts in cells lining the small tubes that help to make urine. In advanced disease, the cancer has spread inside the kidney, and may or may not have spread to nearby lymph glands. NICE has previously recommended two drugs for advanced renal cell carcinoma, sunitinib and pazopanib- both as first-line treatments.

Commenting on the draft guidance, Professor Carole Longson, Health Technology Evaluation Centre Director said: "NICE was asked by the Department of Health to look at axitinib for people who have already been treated with a cytokine or a drug known as a kinase inhibitor. This draft guidance recommends that the NHS provides axitinib for these patients. Although, this recommendation has not changed since the previous draft guidance, the updated draft includes some clarification around prescribing axitinib.

"The independent appraisal committee carefully considered the available evidence, including the discount offered by the company that market the drug and concluded that axitinib should be offered by the NHS."

As NICE was asked by the Department of Health to look at the use of axitinib within its licensed indication for those previously treated with sunitinib (a kinase inhibitor), the use of axitinib after treatment with other tyrosine kinase inhibitors, such as pazopanib, is not subject to statutory funding.

The draft guidance is now with consultees, who have the opportunity to appeal against it. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments. 

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