Pioneering treatment that could keep myeloma at bay for five years approved
Thousands of myeloma patients across the UK could get a new lease of life thanks to a ground-breaking treatment shown to offer remissions of five years.
The treatment combines three drugs – daratumumab (Darzalex®), lenalidomide (Revlimid®) and dexamethasone (DRD) – and is aimed at newly-diagnosed myeloma patients who are not eligible for a stem cell transplant.
Nearly 4,000 myeloma patients each year are expected to benefit from this new life-extending treatment on the NHS.
Shelagh McKinlay, Director of Research and Advocacy at blood cancer charity Myeloma UK, said: “DRD is a game changer that will make a tremendous difference to patients’ quality of life, and finally help to close the gap in survival between people who are eligible for a stem cell transplant and those who are not.
“Not only has DRD been shown to nearly double current remission times, but it gets myeloma under control faster.
“Approximately two-thirds of newly-diagnosed myeloma patients are not eligible for a transplant, and now, at long last, they’ll be able to benefit from a life-extending treatment that could give them five precious years with their loved ones.
“We will continue to campaign to make sure that people living with myeloma get access to the latest, most effective treatments when they need them. And we are committed to working with NICE, NHS England and other key partners towards this goal.
“Until we find a cure, it is vital that all myeloma patients are allowed to live a full life for as long as possible.”
Until now, the most common treatment for newly-diagnosed patients ineligible for a transplant has consisted of dexamethasone and lenalidomide. But patients’ average remission following treatment was just three years.
Clinical trials showed that adding daratumumab to the mix and offering DRD to these patients as soon as they were diagnosed increased their remission time by a further two years, keeping their myeloma at bay for a total of five years on average.
Daratumumab has proven to be a real step change for myeloma treatment. Over the past few years, the drug has been introduced earlier and earlier in patients’ treatment pathways with promising results.
Daratumumab has been available for newly-diagnosed patients eligible for a stem cell transplant across the UK since December 2021. But, until now, newly-diagnosed patients ineligible for a transplant had to wait until their myeloma had returned to be allowed access to daratumumab.
Prof Graham Jackson, Chief Clinical and Scientific Officer at Myeloma UK, said: “This is fantastic news for patients across the UK. DRD has proven through the MAIA clinical trial to be a more effective anti-myeloma therapy for older, newly-diagnosed patients who are not eligible for a transplant. It represents an important step forward in improving outcomes for older patients.”
What does this mean for patients?
The decision means that all patients in the UK can now access daratumumab at diagnosis.
DRD is one of the most effective treatments for newly diagnosed patients who are older, frailer, and unsuitable for stem cell transplantation.
The MAIA clinical trial showed that DRD not only increased the speed and depth of response but also extended remission times and life expectancy for myeloma patients when compared to the current treatment option, lenalidomide and dexamethasone (RD).
What is daratumumab?
Daratumumab (Darzalex®) belongs to a group of drugs known as monoclonal antibodies. It works innovatively by harnessing the body’s immune system.
Daratumumab is a synthetic antibody designed to target myeloma cells by detecting a protein commonly found on the surface of myeloma cells called CD38. When daratumumab finds and attaches to CD38, it makes the myeloma cell more visible to the immune system. It helps the patient’s immune system locate and kill myeloma cells.
Daratumumab was the first monoclonal antibody used to treat myeloma and has been available through the NHS in England and Wales since 2018 and in Scotland since 2017. However, it was not approved for use in treating older, frailer myeloma patients at the time of diagnosis – until now.
The National Institute of Healthcare Excellence (NICE) and Scottish Medicines Consortium initially approved daratumumab as a standalone treatment for patients whose myeloma had returned for the third time.
In 2019, NICE and the SMC approved daratumumab in combination with bortezomib and dexamethasone as a treatment for patients whose myeloma has come back once.
In 2021, NICE and the SMC approved daratumumab in combination with bortezomib, thalidomide and dexamethasone as a treatment for newly-diagnosed myeloma patients who were fit enough for a stem cell transplant.
What about patients in Northern Ireland?
In Northern Ireland, the Department for Health decides which treatments to fund. They usually follow the recommendations made by NICE or the SMC.
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