NICE kidney cancer guidance
The following guidance documents are available via the National Institute for Health and Care Excellence (NICE) website.
The guidance documents have been written for healthcare professionals, and some of the wording might be difficult to understand; however, they will give you good background information to the treatments currently available for kidney cancer (renal cell carcinoma, RCC).
NICE interventional procedure guidance:
- Irreversible electroporation for treating renal cancer (IPG443). February 2013
- Laparoscopic cryotherapy for renal cancer (IPG405). August 2011
- Laparoscopic nephrectomy (including nephroureterectomy) (IPG136). August 2005
- Laparoscopic partial nephrectomy (IPG151). January 2006
- Percutaneous cryotherapy for renal cancer (IPG402). July 2011
- Percutaneous radiofrequency ablation for renal cancer (IPG353). July 2010
- Single-port laparoscopic nephrectomy (IPG414). November 2011
- Improving outcomes in urological cancers (CSG2). September 2002
- Suspected cancer: recognition and referral (NG12). June 2015
Please note: The guidelines for improving outcomes in urological cancers (CSG2) are extremely out-of-date and new guidelines are desperately needed. We are in the early stages of working with NICE to ensure updated guidelines are put in place.
NICE quality standards:
NICE technology appraisal guidance (for more information about NICE technology appraisals, please visit our Kidney Cancer Treatments page):
- Axitinib for treating advanced renal cell carcinoma after failure of prior systemic treatment (TA333). February 2015
- 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 (TA178). August 2009
- Everolimus for the second-line treatment of advanced renal cell carcinoma (TA219). April 2011
- Pazopanib for the first-line treatment of advanced renal cell carcinoma (TA215). February 2011
- Sunitinib for the first-line treatment of advanced and/or metastatic renal cell carcinoma (TA169). March 2009
- Denosumab for the prevention of skeletal-related events in adults with bone metastases from solid tumours (TA265). October 2012
- Renal cell carcinoma (metastatic, treated) – nivolumab (TA417). November 2016
- Cabozantinib for previously treated advanced renal cell carcinoma (TA463). August 2017
- Lenvatinib with everolimus for previously treated advanced renal cell carcinoma (TA498). January 2018
- Tivozanib for treating advanced renal cell carcinoma (TA512). March 2018
- Nivolumab with ipilimumab for untreated advanced renal cell carcinoma (TA581). May 2019. More evidence on nivolumab with ipilimumab is being collected until August 2021. After this NICE will decide whether or not to recommend it for use on the NHS and update the guidance. It will be available through the Cancer Drugs Fund until then.
- Avelumab with axitinib for untreated advanced or metastatic renal cell carcinoma (ID1547). Expected publication date: 08 March 2020
- Pembrolizumab with axitinib for untreated metastatic renal cell carcinoma (ID1426). Expected publication date: 27 May 2020
- Renal cell carcinoma (advanced) – axitinib (review TA333), everolimus (review TA219), sorafenib and sunitinib (part review TA178) (after systemic treatment (ID897). This multiple technology appraisal (MTA) has been suspended. Following a series of changes to the technologies due to be appraised, NICE considers there is limited value to the NHS in conducting an MTA of the remaining second line renal cell carcinoma therapies (axitinib, sorafenib and sunitinib). NICE has decided to remove this appraisal from its current work programme.
Some of the treatments have not been approved by NICE and are not routinely available in NHS England, however. These are:
- Bevacizumab, sorafenib and temsirolimus as first drug treatments for people with advanced and/or metastatic renal cell carcinoma (TA178)
- Sorafenib, sunitinib and everolimus as second drug treatments for people with advanced and/or metastatic renal cell carcinoma (TA 178 and TA 219).
The NICE pathway for the treatment of renal cancer can be found here:
Related national policy on the treatment of urological cancers and cancer in general can be found at the following links:
- NHS England: Manual for prescribed specialised services. January 2014. Section 105 (page 236)
- NHS England: B14. Specialised Urology. NHS Care and Clinical Reference Groups.
- Department of Health: NHS Outcomes Framework 2014-2015. November 2013
- Department of Health: The national cancer strategy: 4th annual report, December 2014
If you need any help finding your way around these guidelines, guidance documents and policies, please email us.