Advanced Kidney Cancer Patients in Scotland to Be Among First to Access New Treatment 

Priscilla Lynch 

October 13, 2021

Patients with advanced renal cell carcinoma (RCC) in Scotland are to be among the first in the world to access a new combination treatment.

The Scottish Medicines Consortium (SMC) has recommended cabozantinib (Cabometyx, Ipsen) in combination with nivolumab (Opdivo, Bristol Myers Squibb) for the first-line treatment of advanced RCC in adults, for use by NHS Scotland.

Cabozantinib offers an additional treatment choice in the therapeutic class of tyrosine kinase inhibitors given in combination with a programmed cell death protein-1 inhibitor for this indication.

Up to approximately 230 eligible Scottish patients could benefit annually from the treatment combination.

Five-year survival rates for kidney cancer in Scotland are on average 15% lower compared with the European average and the lowest among the devolved nations of the UK. Approximately 1000 new cases of kidney cancer are diagnosed in Scotland each year.

The SMC's decision to recommend cabozantinib in combination with nivolumab for RCC is supported by phase 3 randomised clinical trial data published in the  New England Journal of Medicine .

At a median follow-up of 18.1 months for overall survival (OS) in adults with previously untreated clear-cell, advanced RCC, the median progression-free survival was 16.6 (95% CI, 12.5-24.9) months with nivolumab plus cabozantinib versus 8.3 (95% CI, 7.0-9.7) months with currently available therapy sunitinib (HR for disease progression or death, 0.51; 95% CI, 0.41-0.64; P<.001).

The probability of OS at 12 months was 85.7% (95% CI, 81.3-89.1%) with nivolumab plus cabozantinib versus 75.6% (95% CI, 70.5-80.0%) with sunitinib (HR for death, 0.60; 98.89% CI, 0.40-0.89; P=.001).

The adverse event profile with cabozantinib and nivolumab remained consistent with previous reports of each agent as monotherapy, and no new safety signals were identified among all treated patients.

“With incidence of RCC rising in Scotland over the last decade, this recommendation will mark an important milestone for patients with advanced disease."

"The combination of cabozantinib and nivolumab combines agents which both block the growth of blood vessels in cancer tumours and those which harness the body’s immune system to help find and fight cancer,” said Prof Robert Jones, Professor of Clinical Cancer Research, University of Glasgow.

This article originally appeared on Univadis, part of the Medscape Professional Network.

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