We are very disappointed by the Scottish Medicines Consortium’s (SMC) decision not to recommend cabozantinib (Cabometyx) for use within NHS Scotland as a first-line treatment option for people with intermediate-risk or poor-risk advanced renal cell carcinoma (RCC).

This is despite cabozantinib’s proven effectiveness at significantly extending progression-free survival in these patients compared to first-line sunitinib, as shown in the CABOSUN study where median progression-free survival was 8.6 months with cabozantinib versus 5.3 months for sunitinib. In addition, anecdotal evidence suggests that cabozantinib is particularly effective against bone metastases, an area of unmet need in the treatment of advanced RCC.

The SMC gave the reason being that the pharmaceutical company’s justification of the cost of cabozantinib in relation to its health benefits was not sufficient, despite the fact that cabozantinib is a medicine for the treatment of an end-of-life condition.

It is well known that a clinical response to cancer drugs is individual, and some patients respond better than others; we believe that clinicians need to have a choice of drugs to be able to effectively treat kidney cancer patients. The SMC’s decision leaves clinicians in Scotland with a limited choice of drugs with which to treat advanced kidney cancer in the first-line, and is denying patients access to a new type of drug. This decision also has a profound effect on the way Scotland treats cancer patients, leaving people with kidney cancer at a significant disadvantage and more likely to die prematurely compared to England, Wales, the rest of Europe and America.

“Not only is today’s news deeply distressing for kidney cancer patients and their families, it demonstrates the current frustrating and fragmented approach to reviewing cancer medicines in the UK,” said Rose Woodward from the KCSN. “Despite the fact NICE has recently recognised the benefits of cabozantinib for kidney cancer patients in England, the SMC is set to block access for patients in Scotland. An urgent review of this decision is needed and I sincerely hope everyone involved will work hard to reverse this decision and get this drug to the kidney cancer patients who need it.”

The SMC have told us that there are several options now available to the pharmaceutical company; we will, of course, keep you updated with any developments regarding the next steps that we can take to make cabozantinib available to Scottish kidney cancer patients.

Read the information on the SMC website here and the public information summary here