NICE backs use of sunitinib for the treatment of GISTs, but Pfizer to pay for first treatment cycle

The UK'€™s National Institute for Health and Clinical Excellence (NICE), which advises on therapy options for England and Wales, has today published guidance on the use of global pharma behemoth Pfizer'€™s Sutent (sunitinib) for gastro-intestinal stromal tumors (GISTs). This recommends sunitinib as a possible treatment for people with unresectable (non-operable) or metastatic GIST if they have already tried imatinib treatment but it has stopped working, or was not suitable. Sunitinib is recommended on the basis that the cost of the drug for the first treatment cycle is covered by the manufacturer, the NICE pointed out.

GISTs are found in the digestive system, most commonly in the stomach. Many of these tumors are benign and cause few symptoms. If they become malignant and are confined to one area of the stomach or bowel, they can often be removed surgically. Where this is not possible, current NICE guidance recommends that imatinib should be offered to patients as a first line treatment option; however, this is not suitable for all patients with some not able to tolerate the drug whilst others will develop a reduced response to it at over time.Sunitinib works by binding to cancer cells and slowing down the growth of tumors.  

Peter Littlejohns, NICE's Clinical and Public Health Director said: "Gastro-intestinal stromal tumors are difficult to diagnose but it has been estimated that there are around 240 new cases of unresectable and/or metastatic GISTs per year in England and Wales. Today'€™s guidance provides these patients with a further treatment option and represents a positive move by the manufacturer, who, by reducing the cost the National Health Service will have to pay for this treatment, will enable as many eligible patients as possible to access it."

Having initially declined to back the drug for other indications, NICE issued final guidance in March recommending the use of sunitinib as a first-line treatment option for people with advanced and/or metastatic renal cell carcinoma who are suitable for immunotherapy and have an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. NICE subsequently reversed its stance, in part because Pfizer agreed to give the first round of treatment free on the NHS, making it much more cost effective, a tactic similar to this that has been employed by other drugmakers aiming to get their products available on the NHS.