The National Institute for Health and Care Excellence has issued a preliminary decision rejecting first-line use of Ipsen/Exelixis’ Cabometyx in renal cancer on the NHS.

Cabometyx (cabozantinib) is currently routinely available on the NHS as a treatment for adult patients with advanced RCC following prior vascular endothelial growth factor (VEGF)-targeted therapy.

Earlier this year, the drug’s scope was expanded in Europe to include treatment-naïve adults with advanced RCC, on the back of data showing patients given Cabometyx had a median progression free survival of 8.6 months versus 5.3 months for those treated initially with sunitinib (Pfizer’s Sutent), marking a 52 percent reduction in the hazard for progression or death.

However, NICE says while clinical trial evidence shows that cabozantinib extends the period of time until cancer progresses compared with current treatment, the evidence on whether it boosts the overall survival “is less certain”.

“It is at least as effective as current treatment, but it is not clear how much further benefit it offers,” the cost watchdog said, and concluded that cost-effectiveness estimates are higher than what it normally considers acceptable for routine NHS use.

Ewan McDowall, general manager of Ipsen UK & Ireland, said the firm remains “committed to working with NICE”, while the two sides further analyse the data ahead of the final guidance to be published later this year.

Kidney cancer is the seventh most common cancer in the UK, with around 12,500 new cases of the disease every year.