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NICE recommends Sutent (sunitinib) for advanced kidney cancer

by Henry Scowcroft | Analysis

4 February 2009

9 comments 9 comments

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A kidney

NICE has been deliberating over whether to recommend drugs to treat kidney cancer

Six months after their preliminary decision, the National Institute of Health and Clinical Excellence (NICE) today issued its final guidance on the chemotherapy drug Sutent (sunitinib).

The drug will now be available on the NHS to treat patients with advanced kidney cancer.

We’re delighted with this decision.

Regular readers of this blog will remember our disappointment last August when NICE, which decides which drugs and treatments should be available on the NHS, decided initially not to recommend Sutent, along with three other drugs.

This led to an outcry as concerned patients expressed their frustration and anger – many on this blog. We listened to these concerns and fed them back to NICE as part of their consultation process.

Flexible pricing

NICE have reversed their stance in part because the manufacturers of the drug, Pfizer, have agreed to give the first round of treatment free on the NHS, making the treatment much more cost effective.

But even with this discount, the drug is still extremely expensive.

Amongst our recommendations to NICE we noted that we didn’t think their process was appropriate for all drugs, such as those used to treat patients with rarer cancers and those at the end of their life.

In January this year, NICE announced that they were changing the advice they gave to their committees to include more flexibility in these situations. This seems to have played a role in today’s decision, as the report states:

“Although it might be at the upper end of any plausible valuation of such benefits, in this case there was a significant step-change in treating a disease for which there is currently so little to offer patients”.

The decision will make an important difference to many patients with the disease. Sutent is a drug that brings clear benefits. Not only is it more effective than the current treatment (interferon immunotherapy), but – importantly when you are coping with a terminal illness – it has far fewer side-effects.

We hope that the next few years will see many more drugs like this being approved – drugs that have been rationally designed by building on our increasing understanding of basic cancer biology.

And it’s very gratifying to see NICE’s new attitude towards people with terminal illnesses or rare diseases bearing fruit so quickly.

Other three drugs not recommended

However, NICE also issued ‘preliminary’ guidance that three other drugs, Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus), would not be recommended to the NHS, neither as a first-choice treatment, nor to patients for whom Sutent wasn’t suitable, as there wasn’t enough evidence of clinical benefit compared to their high cost.

We hope that this decision will change as more clinical data become available, and, crucially, negotiations with the manufacturers over pricing schemes progress. The decision is open to consultation until 4th March.

We also hope that NICE will continue to turn their good intentions and new ways of working into practical decisions that benefit many more cancer patients, and that drug manufacturers follow the lead that Pfizer have shown in this instance.

Henry


    Comments

  • Mohammad Naeem
    12 July 2011

    dear sir i need the tablets of sutent sunitinib for six month but i am not able to buy them from market, could you please give me the mentioned tablets for some months.
    best regards

  • MRS J. BARNES
    29 August 2009

    Always best to check any side effects with your consultant Mary, or your gp. Sutent has thinned my blood considerably but for me that is a good thing as I have polycythemia (too thick blood as the kidney tumour gets the bone marrow to keep producing red cells) Sutent also has been shrinking my tumours since I started it back in May! Hope you get a good response from it too.
    Jackie.

  • Mary Dawson
    29 August 2009

    I am on Sutent and have had quite a heavy nose bleed is this OK

  • reply
    Kat Arney
    30 August 2009

    Dear Mary,
    We would suggest you contact your doctor if you have any concerns about symptoms or treatment, as we can’t offer medical advice on the blog. If you have questions about your treatment, you may also like to contact our team of trained cancer information nurses. Their contact details are here: http://cancerhelp.cancerresearchuk.org/utilities/contact-us/, and they run a freephone helpline from 9am-5pm, Monday to Friday (except public holidays).

    Best wishes,
    Kat

  • Edie Maher
    14 May 2009

    Has anyone used this Sutent for Thyroid Cancer and if so can you provide me with any information, god or bad?

  • reply
    Kat Arney
    14 May 2009

    Hi Edie,

    You may find more responses to your question on our patient community forum CancerChat: http://www.cancerchat.org.uk/
    Alternatively, please contact our Cancer Information Nurses if you’d like to know more about any particular treatments:
    http://cancerhelp.cancerresearchuk.org/utilities/contact-us/

    Our CancerHelp UK site also has a page called “What’s new in thyroid cancer” which you may find helpful:
    http://cancerhelp.cancerresearchuk.org/type/thyroid-cancer/treatment/whats-new-in-thyroid-cancer-research

    Kat

  • Michael Cox
    14 March 2009

    dear cancer research.my son iain cox had kidney cancer whisch he died of at the age of 31yrs,he was prescribed sutant which he had for approx 6weeks,but because his cancer was so advanced the drug was unable to assist.but it probably did extend his life somewhat which we are glad of.so all in all sutant should be fully avalaible to everyone.

  • Margaret Bevn
    14 March 2009

    If you have had immunotherapy and are not eligible please remember that this drug only buys you a little more time, please don’t go into debt to get it. It is not a cure but hopefully it will soon be the first line defence at diagnosis. For sure the side effects are not as bad as interferon but there are side effects for some and also problems. Please read all the information, not just the positives, before making any financial committment. Consider if the extra months it gives you are really worth paying for, and the financial implications for the family in the future. This is so difficult to do when you live in the world of ‘cancer’ but the fact that some people are selling their homes is so upseting.

  • dogs
    11 February 2009

    I’m not eligible for sutent under this new ruling as I’ve had my first line treatment.

  • Henry Scowcroft
    6 February 2009

    We’ve asked NICE for their view on how this affects people currently undergoing treatment. Here’s their response:

    “The guidance on first line use of sunitinib has been developed on the understanding that the currently available treatment for advanced and/or metastatic renal cell carcinoma is immunotherapy (namely interferon-alfa and interleukin-2). The Institute recognises that there are people who have had or who are currently receiving immunotherapy and wish to clarify the implications of the guidance for these people.

    “Sunitinib can be considered as a treatment option for those people with advanced and/or metastatic RCC who are currently receiving immunotherapy or who have had immunotherapy before the release of our final recommendations to ensure they are not disadvantaged by our proposed guidance.”

    So it looks like you may well be eligible for Sutent, even though you’re already receiving interferon. The best thing to do now is to get in touch with your doctor to discuss the next steps. Best of luck.

    Henry

  • MRS J. BARNES
    4 February 2009

    As a kidney cancer sufferer on interferon as it was the only drug available due to postcode lottery, it would seem I’m not eligible for sutent under this new ruling as I’ve had my first line treatment. This is unfair and unjust I want to live like any other patient for as long as I possibly can. What NICE have done is cheat a lot of patients on this ruling as we are not eligible to try sutent! I hope it helps those very few who will have access to it but what about the rest of us?

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    Comments

  • Mohammad Naeem
    12 July 2011

    dear sir i need the tablets of sutent sunitinib for six month but i am not able to buy them from market, could you please give me the mentioned tablets for some months.
    best regards

  • MRS J. BARNES
    29 August 2009

    Always best to check any side effects with your consultant Mary, or your gp. Sutent has thinned my blood considerably but for me that is a good thing as I have polycythemia (too thick blood as the kidney tumour gets the bone marrow to keep producing red cells) Sutent also has been shrinking my tumours since I started it back in May! Hope you get a good response from it too.
    Jackie.

  • Mary Dawson
    29 August 2009

    I am on Sutent and have had quite a heavy nose bleed is this OK

  • reply
    Kat Arney
    30 August 2009

    Dear Mary,
    We would suggest you contact your doctor if you have any concerns about symptoms or treatment, as we can’t offer medical advice on the blog. If you have questions about your treatment, you may also like to contact our team of trained cancer information nurses. Their contact details are here: http://cancerhelp.cancerresearchuk.org/utilities/contact-us/, and they run a freephone helpline from 9am-5pm, Monday to Friday (except public holidays).

    Best wishes,
    Kat

  • Edie Maher
    14 May 2009

    Has anyone used this Sutent for Thyroid Cancer and if so can you provide me with any information, god or bad?

  • reply
    Kat Arney
    14 May 2009

    Hi Edie,

    You may find more responses to your question on our patient community forum CancerChat: http://www.cancerchat.org.uk/
    Alternatively, please contact our Cancer Information Nurses if you’d like to know more about any particular treatments:
    http://cancerhelp.cancerresearchuk.org/utilities/contact-us/

    Our CancerHelp UK site also has a page called “What’s new in thyroid cancer” which you may find helpful:
    http://cancerhelp.cancerresearchuk.org/type/thyroid-cancer/treatment/whats-new-in-thyroid-cancer-research

    Kat

  • Michael Cox
    14 March 2009

    dear cancer research.my son iain cox had kidney cancer whisch he died of at the age of 31yrs,he was prescribed sutant which he had for approx 6weeks,but because his cancer was so advanced the drug was unable to assist.but it probably did extend his life somewhat which we are glad of.so all in all sutant should be fully avalaible to everyone.

  • Margaret Bevn
    14 March 2009

    If you have had immunotherapy and are not eligible please remember that this drug only buys you a little more time, please don’t go into debt to get it. It is not a cure but hopefully it will soon be the first line defence at diagnosis. For sure the side effects are not as bad as interferon but there are side effects for some and also problems. Please read all the information, not just the positives, before making any financial committment. Consider if the extra months it gives you are really worth paying for, and the financial implications for the family in the future. This is so difficult to do when you live in the world of ‘cancer’ but the fact that some people are selling their homes is so upseting.

  • dogs
    11 February 2009

    I’m not eligible for sutent under this new ruling as I’ve had my first line treatment.

  • Henry Scowcroft
    6 February 2009

    We’ve asked NICE for their view on how this affects people currently undergoing treatment. Here’s their response:

    “The guidance on first line use of sunitinib has been developed on the understanding that the currently available treatment for advanced and/or metastatic renal cell carcinoma is immunotherapy (namely interferon-alfa and interleukin-2). The Institute recognises that there are people who have had or who are currently receiving immunotherapy and wish to clarify the implications of the guidance for these people.

    “Sunitinib can be considered as a treatment option for those people with advanced and/or metastatic RCC who are currently receiving immunotherapy or who have had immunotherapy before the release of our final recommendations to ensure they are not disadvantaged by our proposed guidance.”

    So it looks like you may well be eligible for Sutent, even though you’re already receiving interferon. The best thing to do now is to get in touch with your doctor to discuss the next steps. Best of luck.

    Henry

  • MRS J. BARNES
    4 February 2009

    As a kidney cancer sufferer on interferon as it was the only drug available due to postcode lottery, it would seem I’m not eligible for sutent under this new ruling as I’ve had my first line treatment. This is unfair and unjust I want to live like any other patient for as long as I possibly can. What NICE have done is cheat a lot of patients on this ruling as we are not eligible to try sutent! I hope it helps those very few who will have access to it but what about the rest of us?