NICE rejects combination treatment for multiple myeloma

pharmafile | August 27, 2021 | News story | Medical Communications  

NICE does not recommend daratumumab (Darzalex, Janssen Cilag), plus bortezomib, thalidomide and dexamethasone, as a treatment option for untreated multiple myeloma in adults who are eligible for an autologous stem cell transplant.

Currently, most individuals with this condition receive a combination of bortezomib plus thalidomide and dexamethasone prior to their stem cell transplant.

The company proposed that this combination plus daratumumab should be offered as an alternative first-line treatment, and should also be considered for a short time after the transplant.

Clinical trial evidence suggests that people treated with daratumumab plus bortezomib, thalidomide, and dexamethasone live longer and have more time before their tumour progresses, compared to individuals treated with bortezomib plus thalidomide and dexamethasone alone.

However, evidence on the long-term effectiveness of the daratumumab combination treatment is uncertain. The committee also would have liked the economic model to consider the additional costs and benefits of lenalidomide maintenance therapy after treatment, which is widely used in NHS practice.

The most likely cost-effectiveness estimate for the daratumumab combination treatment is higher than NICE normally considers an acceptable use of NHS resources. Therefore, daratumumab plus bortezomib, thalidomide and dexamethasone cannot be recommended for routine use in the NHS.

Multiple myeloma is a form of cancer that arises from white blood cells in the bone marrow. The term multiple myeloma refers to the presence of more than one site of affected bone at the time of diagnosis.

Lilly Subbotin

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