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Myeloma UK welcomes NICE approval of first routinely available triplet at first relapse

Patient advocacy news // 19th March 2021

The National Institute for Health and Care Excellence (NICE) has approved the use of carfilzomib (Kyprolis®), lenalidomide (Revlimid®), and dexamethasone for the treatment of myeloma patients at first relapse (second line). The triplet combination will be accessible for patients whose previous treatment has included bortezomib (Velcade®).

This treatment is the second triplet to be made available through the NHS at second line and the first to be made routinely available.   This approval not only gives myeloma patients increased treatment options at second line but gives more patients access to a triplet combination. It is particularly beneficial for patients who are sensitive to bortezomib (Velcade®) who would not be eligible for daratumumab (Darzalex®), bortezomib and dexamethasone.

Research has consistently shown that triplet combinations are more effective than a doublet combination for the treatment of myeloma. Carfilzomib, lenalidomide, and dexamethasone has also been shown to be an effective combination, improving median remission time (26 months) compared to lenalidomide and dexamethasone alone (17 months).

This approval follows the draft ‘no’ recommendation issued by NICE in September 2020. Since then, Myeloma UK has been working with patients, clinicians, and industry to change this draft ‘no’ into a positive recommendation in line with Scotland and Northern Ireland.

Laura Kerby, Chief Executive of Myeloma UK said:

“This approval is great news for the myeloma community and we are delighted with the decision. Myeloma is an incurable and very individual cancer and this decision means more patients can benefit from the better responses to treatment at an early stage that a triplet regimen can offer. The NICE decision also means that, regardless of where they live in the UK, patients now have equal access to the treatment they need and want.

Myeloma UK is committed to ensuring that patients benefit from the latest therapies like triplets, and this is the most recent example of how our approach to partnership working makes that a reality.”

Franko Kowalczuk, Patient expert said:

“It’s fantastic news that a new treatment combination of carfilzomib, lenalidomide, and dexamethasone has been approved as a second line treatment for myeloma. Many people like me will benefit from this with longer remission periods, increased quality of life, and ultimately a longer survival period. It was really important for me to contribute to this treatment review and give myeloma patients a voice and some hope.”

Carfilzomib is a proteasome inhibitor and is manufactured by the pharmaceutical company Amgen. You can read more about carfilzomib in our treatment guide.

What does this mean for patients?

Patients at first relapse (second line) who have previously been treated with bortezomib can now receive carfilzomib in combination with lenalidomide and dexamethasone.

The clinical benefits of this treatment were explored in a clinical trial called ASPIRE which showed an increase of remission time and overall survival for myeloma patients.

This approval will increase the treatment options for patients who have relapsed after one prior therapy.

What about patients in Scotland and Northern Ireland?

For patients in Scotland, Carfilzomib, lenalidomide, and dexamethasone was approved for use through NHS Scotland in October 2020.

In Northern Ireland, the Department for Health makes decisions on which treatments to fund. They usually follow the recommendations made by NICE.

Further information

If you have any questions or comments on the decision please email policy@myeloma.org.uk or call the Myeloma Infoline on 0800 980 3332 (UK) or 1800 937 773 (Ireland) during office hours, Monday to Friday.