August 7, 2008
Kidney Cancer Sufferers Facing Drug Therapy Blow
By JANE KIRBY
PATIENTS with advanced kidney cancer will be denied four treatments on the NHS under new guidelines published yesterday.The National Institute for Health and Clinical Excellence (Nice) issued draft guidance rejecting the drugs Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus).
Primary care trusts in Merseyside and Cheshire had already agreed to start offering Sutent on the NHS, as reported by the Daily Post in December last year.
But this decision is now likely to be subject to review.
Charities expressed outrage at Nice's decision, saying it left patients only one treatment option - interferon - to which many do not respond.
Professor John Wagstaff, from the South Wales Cancer Institute, said there was "no point" in him accepting referrals for people with advanced kidney cancer, as around 75% of them "do not gain any real benefit" from interferon.
Broadcaster James Whale, who lost a kidney to cancer in 2000, said the guidance would "mean an early death sentence for many" if it was not revised.
The draft guidance, which is subject to appeal, rejects the drugs, saying they are not cost effective for patients with advanced and/or metastatic kidney cancer.
The medicines do not cure the cancer, but extend a person's life by a matter of months.
Patients already on the therapies should continue until they and their doctors consider it appropriate to stop, the guidance said.
Every year, up to 7,000 people in the UK are diagnosed with kidney cancer.
Of these, around 1,700 patients will be diagnosed with advanced kidney cancer and at any one time around 3,600 people are living with the advanced form.
Professor Peter Littlejohns, clinical and public health director at Nice, said: "The decisions Nice has to make are some of the hardest in public life.
"NHS resources are not limitless, and Nice has to decide what treatments represent best value to the patient as well as the NHS.
"Although these treatments are clinically effective, regrettably, the cost to the NHS is such that they are not a costeffective use of NHS resources.
"Two of the manufacturers have developed proposals which may have the effect of reducing the cost of the drugs."
Prof Littlejohns said there were no treatments that reliably cured advanced or metastatic kidney cancer.
"The main objective is to relieve physical symptoms and maintain general functions," he said.
"Bevacizumab, sorafenib, sunitinib or temsirolimus have the potential to extend progression-free survival by five to six months, but at a cost of pounds 20,000 - pounds 35,000 per patient per year.
"If these treatments were provided on the NHS, other patients would lose out on treatments that are both clinically and cost effective."
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