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Today, the National Institute for Health and Care Excellence (NICE), have recommended cabozantinib (Cabometyx) as an option for treating advanced renal cell carcinoma (RCC) after prior treatment with a vascular endothelial growth factor (VEGF) targeted therapy (e.g., sunitinib or pazopanib).
This follows a protracted appraisal process involving three committee meetings and two appraisal consultation documents before the final appraisal document was released. Cabozantinib is a once-daily oral tablet which targets multiple pathways involved in the growth of tumours. Cabozantinib has been shown to significantly extend overall survival and progression free survival compared with everolimus, with over five times more patients responding to treatment. Because of its multi-targeted approach, cabozantinib would likely have additional benefits for some groups of patients.
Although not discussed during the appraisal meetings, there is anecdotal evidence that cabozantinib is particularly effective against bone metastases. Kidney Cancer Support Network (KCSN) has heard from a number of patients who confirm this activity, and clinicians are also recommending cabozantinib specifically for patients with bone metastases. The recommendation of cabozantinib for use within NHS England and Wales is, therefore, fantastic news for this group of patients, and is a welcome addition to the arsenal of drugs now available to clinicians for the treatment of advanced kidney cancer in the second-line and beyond. This decision also comes a month after cabozantinib became available within NHS Scotland, thereby ensuring equity of access to the drug throughout Great Britain.
Rose Woodward, a survivor of kidney cancer and founder of KCSN said “This is tremendous news for kidney cancer patients with metastatic disease. We have been eagerly awaiting this news from NICE for many months and it will be a great relief to patients and their families, particularly those patients with metastatic bone tumours, to know that expert clinicians now have cabozantinib available. Kidney cancer is a desperately difficult cancer to treat and NHS patients need to know they can access the latest treatments when they need them. I am really grateful that NICE and the manufacturer have worked together to ensure patients have access to this new clinically effective drug.”