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

Current NHS treatment for untreated advanced renal cell carcinoma (RCC) includes sunitinib, pazopanib, tivozanib or cabozantinib.

NICE concluded that clinical trial evidence shows that, for people with untreated advanced RCC, Bavencio plus axitinib increases how long people live without their disease getting worse compared with sunitinib, while early data also suggest the therapy increases survival.

However, it says this is uncertain because the final trial results are not available yet, and the Institute also noted the lack of trials comparing Bavencio/axitinib directly with other current options.

Bavencio plus axitinib has the potential to be cost effective, but more evidence is needed to address these uncertainties and update the economic model, which is why its use will be funded via the Cancer Drugs Fund while further data is collected.

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.

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.