Bevacizumab (first-line), sorafenib (first- and second-line), sunitinib (second-line) and temsirolimus (first-line) for the treatment of advanced and/or metastatic renal cell carcinoma

There are a number of ongoing trials which are actively recruiting participants and which are relevant to this appraisal. Some of these trials are investigating the optimum sequences of treatment. Full details of ongoing research can be found at the National Institute for Health Research Clinical Research Network, ClinicalTrials.gov and Current Controlled Trials.

The Assessment Group considered that the following well-conducted RCTs reporting health-related utility values in accordance with the NICE methods guide could be of value:

• RCTs to investigate the effectiveness of temsirolimus and sorafenib as first-line treatments (both as monotherapy) compared with best supportive care in people who are unsuitable or have contraindications for immunotherapy and who have a poor or intermediate prognosis.

• RCTs of sunitinib as a second-line treatment in people in whom immunotherapy has failed.

• RCTs of sorafenib as a second-line treatment in whom first-line non-immunotherapy treatment (including sunitinib) has failed and who are unsuitable or have contraindications to immunotherapy.