The NHS in England is set to be among the first health services to adopt a new myeloma treatment, it was announced today.
The National Institute for Health and Care Excellence (NICE) announced its backing for belantamab mafodotin 鈥� but also faced criticism for rejecting the first 鈥榪uadruple therapy鈥� for multiple myeloma.
According to draft guidance, belantamab mafodotin would be offered with bortezomib and dexamethasone to patients who have been unsuccessful with lenalidomide treatments.
The new treatment is the first to target the protein BCMA, found on myeloma cancer cells. NICE said the DREAMM-7 trial of the treatment has found significant benefits. It led to 71% of patients being free from disease progression after a year, a 20-percentage point improvement on existing treatments.
NICE said British patients would now be 鈥渁mong the first in the world鈥� to receive the treatment.
Meanwhile, campaigners have vowed to reverse a proposal to reject the first 鈥榪uadruplet treatment鈥� for multiple myeloma for use in England.
The proposed treatment would add the monoclonal antibody isatuximab to bortezomib, lenalidomide and dexamethasone, and is known as IsaVRD.
In early draft guidance, NICE have rejected the quadruple therapy. The charity Myeloma UK says the treatment would be a 鈥済ame changer鈥� for thousands of patients.
The NICE appraisal committee agrees that the addition of isatuximab to treatment increases the survival of patients before the disease deteriorates, according to the current findings of a continuing clinical trial. But, it says, isatuximab is being tested with a triple combination, of bortezomib, lenalidomide and dexamethasone, that is not used in the NHS. The appraisal committee says there has been no direct comparison with current combinations in use within the NHS, such as daratumumab, lenalidomide and dexamethasone 鈥� although, it says, it is 鈥渓ikely鈥� to work as well as these combinations.
The Myeloma UK director of research and advocacy Shelagh McKinlay said: 鈥淲hile this news is very disappointing, it is important to remember that NICE鈥檚 decision is not final. The approval process can be lengthy, and it is not unusual for treatments to go through at least two appraisal committees before they鈥檙e made available on the NHS.
鈥淎s the first quadruplet combination for transplant-ineligible patients, IsaVRD could be a game-changer for thousands of people. Not only does it use four separate drugs to attack myeloma cells in different ways, but it also offers more flexibility to manage side effects.
鈥淲e firmly believe people with myeloma should have access to IsaVRD and we are doing everything we can to get this treatment across the line.
鈥淯ntil we have a cure, it is absolutely vital that all patients are given as many options to control their disease as possible.鈥濃��
Source: NICE/Myeloma UK
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