Sunitinib is recommended as a possible first drug treatment for people with advanced and/or metastatic renal cell carcinoma if:
- immunotherapy (for example, interferon alfa) would be suitable for them and
- they are mobile and can do light housework or office work.
When assessing people with disabilities, healthcare professionals should bear in mind that a person’s disability might also affect their level of physical activity. They should make adjustments for this.
Specialists should not stop prescribing sunitinib for people who were already taking it when the guidance was issued. These people should be able to carry on taking sunitinib until they and their specialist decide that it is the right time to stop treatment.
NICE has been appraising the use of bevacizumab, sorafenib, sunitinib and temsirolimus for the treatment of advanced and/or metastatic renal cell carcinoma. Following the independent advisory Committee meeting on 14 January 2009 NICE has decided to split this appraisal in two in order to get guidance out to the NHS as quickly as possible.
NICE is also appraising the use of bevacizumab, sorafenib and temsirolimus for first-line treatment options for advanced and/or metastatic renal cell carcinoma and the two drugs also licensed for second-line treatment of advanced or metastatic renal cell carcinoma, sorafenib and sunitinib, guidance is expected to be published later this year.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.