National Institute for Health and Clinical Excellence (NICE)
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New combination treatment for patients with advanced kidney cancer

Adults with advanced renal cell carcinoma can now be offered avelumab with axitinib as a first line treatment option on the Cancer Drugs Fund (CDF), NICE has said in final draft guidance.

The new combination therapy, which uses the body’s own immune system to attack cancer cells and helps to prevent tumour growth, could benefit around 1,600 patients per year in England.

Renal cell carcinoma is a kidney cancer that starts in cells lining the small tubes that help to make urine. In advanced disease, the tumour has spread inside the kidney, but may or may not have spread to nearby lymph glands. In metastatic renal cell carcinoma, the tumour has spread beyond the lymph glands to other parts of the body.

Over the clinical trial period, people taking avelumab plus axitinib lived without their disease getting worse for an average of around 5 months longer than people taking sunitinib, a treatment recommended by NICE in 2009.

Avelumab plus axitinib also has the potential to be cost effective, but more evidence is needed because final trial results are not yet available. This combination treatment will be available on the CDF for untreated advanced renal cell carcinoma at a confidential discounted price.

Meindert Boysen, deputy chief executive and director of the centre for health technology evaluation at NICE, said: “The committee heard from patient representatives that having more first line treatment options for advanced renal cell carcinoma would be welcomed, as it would allow for more individualised treatment plans to better control the disease.

“We’re therefore pleased that, because of the joint working between the two companies, NHS England and NHS Improvement and NICE, eligible patients with advanced renal cell carcinoma will be able to access this combination therapy from today on the CDF, while more clinical data is collected.”

Professor Peter Johnson, NHS clinical director for cancer said: “As well as treating tens of thousands of people for cancer during the coronavirus pandemic, the NHS continues to introduce the latest, most innovative cancer treatments for patients, like this one, thanks to pharmaceutical companies working constructively with the NHS.”

Avelumab is administered via a drip every 2 weeks and axitinib is taken as a pill twice daily.

Other first line treatment options for renal cell carcinoma that have been recommended by NICE include sunitinibpazopanibtivozanib and cabozantinib for routine commissioning and nivolumab with ipilimumab for use on the CDF.

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