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The National Institute for Health and Care Excellence (NICE) has approved the combination of cabozantinib, a tyrosine kinase inhibitor, plus nivolumab, an immunotherapy, for previously untreated people with advanced kidney cancer on the NHS in England and Wales. This brings the two countries in line with Scotland and Northern Ireland, which have allowed NHS access to the combination since 2021, ending the inequality in access within the UK.
Cabozantinib has been recommended for NHS use for previously untreated advanced kidney cancer since 2018, while nivolumab has been in use for previously untreated advanced kidney cancer in combination with ipilimumab (another immunotherapy) since 2022.
The decision was based on the results from the Checkmate 9ER trial, which showed there was a significant improvement in survival and response to treatment for patients on the cabozantinib/nivolumab combination treatment compared to those treated with sunitinib.
The NICE guidance says that the cabozantinib/nivolumab combination should be considered only for kidney cancer patients with intermediate or poor risk disease and if other combinations (nivolumab/ipilimumab or pembrolizumab/lenvatinib) would otherwise be offered.
Rose Woodward, co-founder of Action Kidney Cancer, said the approval is “welcome news for the kidney cancer community,” adding: “It is vitally important that we continue to support and recognise the needs of patients living with this often under-recognised cancer in England and Wales.”
