NICE approves new kidney cancer treatment
MedWire News: The UK National Institute of Health and Clinical Excellence (NICE) has published guidance for the National Health Service (NHS) approving the use of a new drug, Pazopanib, for the treatment of kidney cancer.
"Pazopanib (Votrient, GlaxoSmithKline), is recommended as a first-line treatment option for people with advanced renal cell carcinoma who have not received prior cytokine therapy and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1," say the guidelines.
The drug is an orally administered tyrosine kinase inhibitor that inhibits vascular endothelial growth factor and platelet-derived growth factor receptors on cancer cells, vascular endothelial cells and pericytes, stopping the proliferation of tumor cells and the development of tumor blood vessels, the guidance explains.
NICE based their recommendation on the results of a randomized controlled trial (VEG105192) - conducted by the manufacturer - which compared the effect of a once-daily dose of pazopanib (800 mg) plus best supportive care (n=155) with placebo plus best supportive care (n=78) in patients with advanced renal cell carcinoma. All patients were mobile and able to do light housework or office work (ECOG performance status 0 or 1) at the start of the trial.
The median progression-free survival was significantly longer among patients receiving pazopanib, at 11.1 months, compared with 2.8 months for patients receiving pazopanib plus best supportive care. This meant there was a 60% reduction in risk for disease progression among patients receiving pazopanib versus those receiving placebo.
The manufacturer also carried out an indirect comparison of pazopanib with other active treatment options. They found that pazopanib decreased the risk for death by 37% compared with interferon-α, and appeared to have comparable efficacy with sunitinib in terms of overall survival.
The majority (91%) of patients on pazopanib reported atleast one adverse event, most commonly diarrhoea, hair color change, hypertension, nausea, anorexia, and increased liver enzymes.
Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "Pazopanib will offer patients an additional option to sunitinib, which is also recommended by NICE. Although a direct comparison of pazopanib and sunitinib is not yet available, a trial comparing the two drugs is currently underway and the current patient access scheme proposed by the manufacturer makes pazopanib a cost-effective option for the NHS."
MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2011
By Laura Dean