Newer targeted treatments such as, sunitinib and sorafenib, have recently been developed. These treatments may be helpful for people with locally advanced and metastatic kidney cancer (stages 3 and 4). They are used to try to control the cancer by shrinking it or by slowing its growth. As they are quite new these treatments may not be widely available.

The National Institute for Health and Clinical Excellence (NICE) is an independent organisation that gives advice on which new drugs and treatments should be available on the NHS. NICE has recently published guidance on the use of sunitinib for people with advanced renal cell cancer. It recommends that sunitinib can be used as a first choice treatment for people with advanced or metastatic renal cell cancer if:

• they are able to have immunotherapy (such as interferon alpha) and
• they are fit enough to have the treatment (for example, able to do light housework or office work).

NICE is currently looking at how other drugs such as sorafenib, bevacizumab and temsirolimus can best be used to treat people with renal cell cancer. Guidance is expected to be published later this year.

The Scottish equivalent to NICE, the Scottish Medicines Consortium (SMC), has said sunitinib and sorafenib should not be made available to treat kidney cancer on the NHS in Scotland. This advice may change in the future depending on NICE guidance.

Sunitinib (Sutent®) may be used to treat people with locally advanced kidney cancer (stage 3) or kidney cancer that has spread to other areas of the body (stage 4). It is a type of drug called a multi-targeted kinase inhibitor.  It is taken daily as a tablet and interferes with signals that tell cancer cells to grow. It also works by slowing the growth of new blood vessels within the tumour. Common side effects of sunitinib include skin changes – such as a rash, hair-thinning, raised blood pressure and tiredness.

Sorafenib (Nexavar®) may be used to treat people with stage 3 or stage 4 kidney cancer who are no longer being helped by treatment with interferon-alpha (IFN) or interleukin-2 (IL-2), or for whom these drugs are not suitable. It is a type of drug called a multikinase inhibitor and is taken daily as a tablet. It is designed to stop cancer cells from growing and to prevent the cancer from developing new blood vessels. Common side effects include diarrhoea, skin reactions, and tiredness.