Three different appraisals in the pipeline for 2017 from NICE

Earlier this year, Kidney Cancer UK sent comments to the National Institute for Health and Care Excellence (NICE) for three different appraisals.  Our aim is to highlight the innovative features of the medicines and most importantly illustrate that people with advanced kidney cancer need as many different treatment options as possible. These drugs should be available to the British public.

• Appraisal 591: Cabozantinib. Both appraisal meetings have taken place and we expect the result of these meetings to be announced in April 2017.

Cabozantinib is a VEGF receptor inhibitor, which aims to stop tumour growth and blood vessel formation. It is for use as a second-line tyrosine kinase inhibitor (TKI) which means you would use it after you have been on prior TKI treatment (pazopanib or sunitinib).
 

• Appraisal 591: Tivozanib. Two appraisal meetings are due to take place: on July 12 and September 2017. The result of these meetings is due to be announced in December 2017.

Tivozanib is a VEGF receptor inhibitor and targets all three VEGF receptors. It aims to stop tumour growth and blood vessel formation. It is for use as a second-line TKI which means you would use it after you have been on prior TKI treatment (pazopanib or sunitinib).
 

• Appraisal 1029: Lenvatinib/everolimus combination. Two appraisal meetings are due to take place: on July 12 and September 2017. The result of these meetings is due to be announced in December 2017.

Lenvatinib is a multiple kinase inhibitor, including all three VEGF receptors. Everolimus is an mTOR inhibitor. Both aim to stop tumour growth and blood vessel formation and together it is hoped that they will act to increase the overall survival gained. The combination would be used as a second-line treatment, which means you would use it if you have previously taken a TKI (pazopanib or sunitinib).
 
If the appraisals are successful, three new drugs could be used by the NHS to treat advanced kidney cancer. However, the NICE appraisals are yet to take place and significant pressure is likely to be put on the pharmaceutical industry to discuss the prices of these drugs. NICE have a strict protocol which looks at a cost-benefit analysis and QALY (quality adjusted life years) limit of £30000 https://www.nice.org.uk/advice/lgb10/chapter/judging-the-cost-effectiveness-of-public-health-activities. We will let you know the outcome of these appraisals as soon as possible; April for cabozantinib and December for the other two appraisals. If anyone has been on any of these drugs we would like to hear from you, to learn about your experiences. Kidney Cancer UK hopes advanced kidney cancer patients get an increase in treatment choice in the near future.
By:
Dr Rebecca Case-Upton BSc (Hons), PhD
Medical Publications, Kidney Cancer UK