The National Institute for Health and Care Excellence (NICE) has recommended NHS use of Merck and Pfizer's immunotherapy Bavencio (avelumab) in combination with axitinib as a first-line treatment for kidney cancer.

Specifically, the drug's use will be funded via the Cancer Drugs Fund (CDF) when used for the first-line treatment of adult patients with advanced renal cell carcinoma (RCC).

The firms highlight that outcomes for patients with advanced RCC remain “unacceptably poor”, with a five-year survival rate of approximately 12% at the latest stage, and that more first-line treatment options are urgently needed.

Bavencio is an immune checkpoint inhibitor targeting PD-L18 and axitinib is an antiangiogenic VEGF-targeted TKI, their complementary mechanisms of action targeting two key pathways that tumours use to grow.

In the JAVELIN Renal 101 study, the combination significantly lowered the risk of disease progression or death by 31%, irrespective of PD-L1 status, compared to sunitinib. Median progression free survival was improved by 5.3 months. The study is ongoing to determine overall survival benefit.

“This positive recommendation from NICE provides patients with advanced renal cancer an effective and well tolerated treatment option with proven benefits in progression free survival and objective response rates from a randomised Phase III trial,” said Professor Amit Bahl, a consultant medical oncologist specialised in renal cell carcinoma.

“This could improve outcomes in this group of patients. The combination of an immunotherapy with a tyrosine kinase inhibitor provides patients a novel treatment option.”

The combination was made available as part of the Early Access to Medicines Scheme (EAMS) in August 2019, which has allowed more than 150 patients to gain earlier access to the treatment throughout the UK.