The National Institute for Health and Clinical Excellence (NICE) yesterday (26 August 2009) issued guidance on the use of bevacizumab, sorafenib, and temsirolimus for the treatment of renal cell carcinoma and the use of sorafenib and sunitinib for second-line treatment options for people with renal cell carcinoma.

Bevacizumab, sorafenib and temsirolimus are not recommended as first-line treatment options for advanced and/or metastatic renal cell carcinoma. In addition, the two drugs also licensed for second-line treatment of advanced or metastatic renal cell carcinoma, sorafenib and sunitinib, are not recommended for this indication. People who are currently being treated with these treatments for advanced and/or metastatic renal cell carcinoma should have the option to continue their therapy until they and their clinicians consider it appropriate to stop.

Professor Peter Littlejohns, Clinical and Public Health Director: “We are very aware that renal cancer is a devastating disease for the individual and their family. We recommended the use of sunitinib for first line renal cancer in March 2009, so one of these new treatments is now available. The evidence to support the use of the other first and second line treatments isn’t strong enough to justify using NHS funds, which could be used for other cancer treatment programmes or in other treatment areas. Our advisory committee used the additional flexibility we have recently given them to give special weight to drugs that extend life, at the end of life, but the benefit was still too small set against their cost.”

The appeal against the Final Appraisal Determination from Roche, Wyeth Pharmaceuticals, James Whale Fund for Kidney Cancer and a joint appeal from Rarers Cancer Forum and Macmillan Cancer Support, have not been upheld.