First personalised myeloma treatment DVRD approved on the NHS

Nearly 2,000 patients in England and Wales could get remissions of over four years after the very first personalised myeloma treatment was approved on the NHS.

A true game-changer, DVRD is tailored to each patient’s depth of response.

It combines daratumumab (Darzalex®), bortezomib (Velcade®), lenalidomide (Revlimid®) and dexamethasone and is aimed at newly-diagnosed patients who are eligible for a stem cell transplant.

Around 1,900 people could benefit from the new treatment each year.

According to the latest trial data, 84% of people on DVRD were still myeloma-free after four years.

The treatment has three phases: induction, which is given before a stem cell transplant; consolidation, which is given immediately after a stem cell transplant; and maintenance.

As part of the induction and consolidation phases patients are given all four drugs.

During the maintenance phase, they then receive a double maintenance of daratumumab and lenalidomide. This drives deeper responses and longer remission times.

As part of this personalised regime, people who have been on maintenance for 24 months and have no detectable myeloma cells in the blood or bone marrow for at least 12 months can then come off daratumumab maintenance. This can help reduce the burden of treatment, including side effects and hospital visits.

The approval of DVRD has been a long time coming, after the treatment was knocked back twice by drug-approval body NICE. Its appraisal committee initially rejected it for use on the NHS in January 2026 and again in May 2026.

Myeloma UK made a strong case for NICE to reconsider, submitted evidence and patient testimonies and, after 18 months of tireless work, finally got the treatment over the line.

Scott Purdon, Head of Patient Advocacy at Myeloma UK said:

“This is fantastic news and shows that personalised treatment is absolutely the future of myeloma care. DVRD has been shown to deliver some of the longest, deepest responses we’ve seen to date for myeloma. It is also more convenient and flexible and means less time spent in hospital for people with myeloma and their families.

While we know that NICE has worked hard and we’re pleased it has approved DVRD, it shouldn’t have taken us 18 months to get here. There’s no skirting around the fact that thousands of patients missed out on a truly life-changing drug combination because of a slow and complex approval system that simply was not designed to quickly assess innovative treatments like DVRD. People with myeloma deserve faster and fairer access to the treatments they so desperately need. This is why we’ve launched the Closer to a Cure report, which calls for urgent change and sets out how we can make it happen if we act together now.

Until we have a cure, it is absolutely vital that people with myeloma get the best chance to keep their cancer at bay and live well for as long as possible.”

The approval of DVRD marks the first time NICE has considered every aspect of the treatment sequence, from induction to maintenance, for transplant-eligible patients.

Daratumumab belongs to a group of drugs known as monoclonal antibodies and works by attaching to a protein present on the surface of myeloma cells. This flags the cell to the immune system and allows it to target and kill the myeloma cell.

Q&A

What is DVRD?

DVRD is a combination treatment used to treat myeloma. It contains four drugs: daratumumab, bortezomib, lenalidomide and dexamethasone.

All these are already being used to treat myeloma but in different combinations. For example, the current induction treatment given to newly-diagnosed myeloma patients who can have a stem cell transplant is DVTD, a combination of daratumumab, bortezomib, thalidomide and dexamethasone.

There are now two approved uses of DVRD. One as a treatment for newly-diagnosed patients who can’t have a stem cell transplant (ineligible) and the other for newly-diagnosed patients who can have a stem cell transplant (eligible).

For transplant-ineligible patients, DVRD is given in two phases: induction and maintenance. In the induction phase, patients get all four drugs. In the maintenance phase, patients come off bortezomib and continue with DRD.
For transplant-eligible patients, DVRD is given in three phases: induction, consolidation and maintenance. In the induction and consolidation phases, patients get all four drugs. In the maintenance phase, patients come off bortezomib and dexamethasone and continue taking daratumumab and lenalidomide as maintenance. Patients who have been on maintenance for at least 24 months and have had no detectable myeloma cells in the blood or bone marrow for at least 12 months, can then come off daratumumab.

What happens next?

A positive recommendation from NICE means clinicians can start prescribing a treatment to eligible patients. A treatment should be made available to patients through the NHS within 90 days of the decision being published. However, it may take some time for the treatment to become available, depending on the treatment itself and the capacity of hospitals to deliver it.

What about people living in Scotland and Northern Ireland?

In Scotland, the Scottish Medicines Consortium makes decisions about which treatments to fund through the NHS. The SMC appraisals of DVRD for myeloma patients who can and cannot have a stem cell transplant will likely start later this year.

In Northern Ireland, the Department for Health can follow guidance issued by either NICE or the SMC but usually follows the guidance issued by NICE.