Patients with terminal kidney cancer are to receive an expensive treatment on the NHS after the medicines watchdog overturned a decision to reject the drug.

The National Institute for Health and Clinical Excellence (NICE) is issuing guidance today that approves Sutent (sunitinib) for patients with advanced or spreading renal cell cancer in England, although the watchdog says that it still considers three other drugs too expensive for general use.

The decision was welcomed as a victory for patients’ groups, a fortnight after all four drugs were fast-tracked into use by politicians in Wales.

NICE ruled last year that four new treatments for kidney cancer, which can extend the lives of patients by about six months, were not cost-effective for use on the NHS.

To the despair of charities, kidney specialists and campaigners, the watchdog said that while Sutent (sunitinib), Avastin (bevacizumab), Nexavar (sorafenib) and Torisel (temsirolimus) had shown benefits in clinical trials, at a cost of about £30,000 a year they were too expensive.

After a high-profile review of access to cancer medicines by Mike Richards, the national cancer director, NICE implemented guidelines last month to make it more flexible on treatments that can prolong the lives of the terminally ill.

Under this revised guidance, the watchdog said that Sutent represented a “step-change” in first-line treatment for advanced renal cell cancer, and could be approved, even at an average cost of £24,000 a year per patient. Without it patients would only be able to have an older treatment, interferon, to which many do not respond.

NICE still considers Avastin, Nexavar and Torisel too costly as first or second-line treatment options.

Last month the Welsh Assembly announced that it would make all four drugs available to patients, but is now expected to revert to the advice from NICE, which covers England and Wales.

Every year kidney cancer is diagnosed in up to 7,000 people in the UK. Of these, about 1,700 patients will have advanced kidney cancer and at any one time about 3,600 people are living with the advanced form.

Andrew Dillon, NICE’s chief cxecutive, said that it was in the best interests of patients to publish its draft advice on Sutent as soon as possible. “Although this final recommendation is subject to appeal we very much hope it will form the basis of our guidance to the NHS,” he said.

“The other three drugs we are looking at will be the subject of further consultation.”

Thomas Powles, Senior Lecturer in Medical Oncology, at St Bartholomew’s Hospital, London, said that the decision represented “the biggest thing to happen in renal cancer in the UK in a very, very long time”.

“This will make a real difference in terms of patients living longer. The value of a life is very difficult to judge in financial terms, and when you have a catastrophic piece of news where life expectancy is measured in a matter of months, drugs that can add a number of further months really are a big deal,” he said.

Rachel Rowson, policy manager at Macmillan Cancer Support, said that the decision was long-overdue. “This is a victory for kidney cancer patients,” she said. “Macmillan will continue to campaign to ensure the other three drugs for kidney cancer are also approved for use on the NHS.”

Johnathan Waxman, Professor of Oncology at Imperial College London, said yesterday that the decision represented a reponse to public pressure. “Sutent will only offered as a first-line treatment, so if people are already on a treatment that doesn’t work, such as interferon, they still won’t be able to get it,” he said. “

“Wales have just approved all four drugs, but will now probably change its mind. What nonsense is this to still have different drugs available in different parts of the country.”

A spokesman for the Welsh Assembly, added: “All four drugs will be available to all those who are currently getting them, but NICE guidance will now stand in Wales and new patients will be offered Sutent as a first-line treatment.”

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