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NICE recommends cabozantinib for advanced renal cell cancer

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The National Institute for Health and Care Excellence has approved a kidney cancer drug that is expected to benefit around 1,000 patients.

It has issued final guidance recommending cabozantinib (Cabomeytx) for patients with advanced renal cell carcinoma.

“I am very pleased that the new evidence submitted means we can recommend cabozantinib”

Carole Longson

Cabozantinib inhibits the growth of new blood vessels within a tumour, and so prevents it spreading. It is used for the treatment of advanced renal cell carcinoma in adults, following treatment with vascular endothelial growth factor (VEGF)-targeted therapy.

Charities have welcomed the move, announced today, which represents a change from the NICE appraisal committee’s earlier draft guidance decision.

The committee had previously found the additional benefits of cabozantinib, when compared with current care, were not sufficient to justify the cost of treatment.

There was also uncertainty about which medicines cabozantinib should be compared with. This meant NICE could not previously recommend the drug, noted the institute.

In response to the draft decision, the drug’s manufacture Ipsen compared cabozantinib with medicines that were more often used in the NHS. It also lowered the cost of treatment to the NHS.

“This is an important day for kidney cancer patients; present and future”

Nick Turkentine

Details of the discount have not been revealed by NICE or the Department of Health. The list price for cabozantinib is £5,143.00 per 30-tab pack applicable to all dosages (20mg, 40mg and 60mg).

As a result of the developments, NICE said its committee could now recommend cabozantinib as a cost-effective, treatment for people who have advanced renal cell carcinoma.

Professor Carole Longson, director of the NICE Centre for Health Technology Evaluation, said: “There are limited treatment options available for people who have advanced kidney cancer, so I am very pleased that the new evidence submitted means we can recommend cabozantinib.”

The NHS in England and Wales is legally obliged to begin funding the drug within three months of NICE’s final decision.

The decision by NICE brings it into line with the Scottish Medicines Consortium, which backed the drug in June.

The charity Kidney Cancer UK said it was “delighted” that NICE had recommended the drug cabozantinib be made available to late-stage kidney cancer patients throughout the NHS.

Professor Carole Longson

Professor Carole Longson

Carole Longson

The data for this drug show that it may offer extended life expectancy to some with advanced stage kidney cancer, noted the charity.

It highlighted that the NHS had previously funded only a “handful” of frontline drugs for the condition and when they failed there was nothing else.

The addition of cabozantinib to the drugs available gives patients more options – many patients requiring fourth and fifth line treatments.

Nick Turkentine, chief executive of Kidney Cancer UK, added: “The facts are there in the research, we have also spoken first-hand to patients who have been involved in trials and the benefits of making cabozantinib available through the NHS are very clear.

“This is an important day for kidney cancer patients; present and future,” he said.

Ewan McDowall, vice president of commercial operations at Ipsen UK and Ireland, highlighted that the firm had also implemented a managed access programme that provided cabozantinib free of charge for patients for the duration of their treatment while NICE assessed the drug.

“To date, nearly 300 patients in the UK have benefited from cabozantinib through this Ipsen initiative, whilst the NICE process took place,” he said. “We are delighted that now any eligible patient in the UK can benefit from cabozantinib. These patients don’t have time to wait.”

More than 12,500 people were diagnosed with kidney cancer in 2014, with its steadily increasing incidence in the UK mainly attributed to lifestyle factors, such as obesity.

Kidney cancer is now the seventh most common cancer in the UK and accounts for 3% of all new diagnoses of cancer.

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