NICE Recommends A New Treatment For Kidney Cancer

NICE has published final guidance for the NHSapproving the use of a new drug to treat kidney cancer.

Pazopanib (Votrient, GlaxoSmithKline), is recommended as a first-line treatment option for people with advanced renal cell carcinoma who have not received prior cytokine therapy and have an Eastern Cooperative Oncology Group (ECOG)performance status of 0 or 1. As agreed under the patient access scheme the manufacturer will also provide pazopanib with a 12.5% discount on the list price and a possible future rebate linked to the outcome of the head-to-head trial, known as the COMPARZ trial, comparing pazopanib and sunitinib, details of which will be confirmed when the COMPARZ trial data are made available.

Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "Pazopanib will offer patients an additional option to sunitinib, which is also recommended by NICE. Although a direct comparison of pazopanib and sunitinib is not yet available, a trial comparing the two drugs is currently underway and the current patient access scheme proposed by the manufacturer makes pazopanib a cost-effective option for the NHS."

Renal cell carcinoma is a kidney cancer (tumour) 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. In March 2009, NICE recommended sunitinib for people with advanced renal cell carcinoma.


About the appraisal

1. The guidance will be available here.

2. The manufacturer of pazopanib agreed a two-part patient access scheme with the Department of Health. Part A of the patient access scheme provides a 12.5% discount from the list price. Therefore the daily acquisition cost of pazopanib is £65.39. Part B of the patient access scheme, the details of which are 'commercial-in-confidence' and cannot be reported, offers a future rebate linked to the head-to-head COMPARZ trial.

3. The end of life considerations did apply to this appraisal in relation to pazopanib compared with interferon-α.

4. The trial evidence presented indicates that pazopanib, can delay progression of the cancer by approximately eight months compared with placebo. This does not address the comparison with active treatments used for this patient group. The Committee appreciated that a head to head trial versus sunitinib is ongoing and considered it appropriate at this time to review the indirect evidence provided by the company. On that basis the Committee considered it acceptable to conclude that pazopanib is likely to be a cost effective use of NHS resources.

[1] This scale is used by doctors and researchers to assess how a patient's disease is progressing, assess how the disease affects the daily living abilities of the patient, and determine appropriate treatment and prognosis.

[2] Technology appraisals TA169


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