New drugs for advanced kidney cancer

This page tells you about the new drugs for advanced kidney cancer that have been in the news. There is information about

• New treatments for advanced kidney cancer
• About NICE

The drugs that have been in the news are all types of biological therapies for kidney cancer that has spread from the kidney to another part of the body. This is also called metastatic or advanced kidney cancer. The drugs are

• Sorafenib (Nexavar)
• Sunitinib (Sutent)
• Temsirolimus (Torisel)
• Bevacizumab (Avastin)

Sorafenib and sunitinib are tyrosine kinase inhibitors or TKIs for short. Tyrosine kinases are chemical messengers (enzymes) that play a part in the growth of cells. These drugs work by blocking a number of signals to the cell, which means that they

• Stop signals between cancer cells that tell them to grow
• Stop cancer cells growing their own blood vessels, which they need for bringing food and oxygen

We know from clinical trials that these drugs can slow down the growth of kidney cancer that has spread and they are licensed in Europe for this use. Clinical trials are still going on and you can find more information about them on our clinical trials database. Choose ‘kidney cancer’ from the drop down menu.

Another drug which works in a similar way is called temsirolimus. In a trial for people with renal cell cancer that had spread, temsirolimus helped them to live longer than if they were treated with the standard treatment - interferon. Temsirolimus has now been approved in Europe for advanced kidney cancer.

Bevacizumab (Avastin) is a monoclonal antibody, another type of biological therapy. It stops cancer cells making blood vessels. It targets a growth factor protein called vascular endothelial growth factor (VEGF). Some kidney cancers make too much of this growth factor. If VEGF is blocked, the cells aren’t able to make blood vessels. Bevacizumab with interferon has also been licensed in Europe for advanced kidney cancer.

In England and Wales, The National Institute for Health and Clinical Excellence (NICE) looked into these new drugs, to decide whether they should be prescribed on the NHS for kidney cancer.

NICE have issued guidance that sunitinib should be available as a first treatment for people with advanced kidney cancer, if they would be suitable for immunotherapy, and are reasonably fit (well enough to do light house work, for example). They do not recommend sunitinib or sorafenib as a second treatment for advanced kidney cancer. They also do not recommend sorafenib, temsirolimus or bevacizumab as a first treatment for advanced kidney cancer. They do not think that these drugs should be used on the NHS because they are not cost effective. Clinical trials using these drugs are continuing though.

You can find more information about research into kidney cancer treatment in our kidney cancer section on CancerHelp UK. There is also more about sorafenib and bevacizumab in our cancer drugs section and more about sunitinib in the kidney questions and answers section.

NICE stands for the National Institute for health and Clinical Excellence. It is an independent organisation set up by the government to decide which drugs and treatments should be available on the NHS in England and Wales. Scotland and Northern Ireland have separate organisations to make these decisions.

NICE considers whether a treatment

• Benefits patients
• Will help the NHS meet its targets
• Is value for money (cost effective)

If NICE recommends a particular treatment, the NHS has to find the money to make the treatment available. NICE don’t provide any extra money to cover the costs.

NICE makes decisions based on

• Evidence from research
• Contributions from patient organisations, health professionals, experts and other interested parties
• Cost effectiveness, including the quality of life adjusted year or QUALY

A QUALY is a tool. It takes into account how a treatment affects how long you may live with a particular condition, the quality of life you get with that treatment, and the cost of the treatment.

It can take a long time for NICE to produce guidance about a treatment - up to 18 months. NICE issue initial guidance and then consult again with all of the interested parties, including patient organisations and medical experts. This means that their recommendations could change after further consultation. Once their final guidance is issued, there is also an appeals process and people or organisations with an interest can appeal against a decision.

There is more information about NICE and how it works in our question and answer section.