This latest update presents critical developments in myeloma treatment appraisals by the National Institute for Healthcare Excellence (NICE) and the Scottish Medicines Consortium (SMC).
Stay informed about the latest recommendations, appeal hearings, and upcoming assessments shaping the treatment options for patients and healthcare professionals.

Recent decisions

Recommended: Daratumumab, lenalidomide (Revlimid®) and dexamethasone

DRD is recommended for newly diagnosed myeloma patients for whom high-dose therapy and stem cell transplantation (HDT-SCT) is unsuitable.

Forward look at upcoming appraisals

Daratumumab in combination with bortezomib (Velcade®), cyclophosphamide and dexamethasone for AL amyloidosis

The decision will now be reevaluated at a third committee meeting on 8 November. Based on the appeal panel’s instructions, the committee will review and reevaluate key data and evidence submitted during the appraisal.

Isatuximab (Sarclisa®), pomalidomide (Imnovid®) and dexamethasone

NICE is currently reevaluating the use of the IsaPd combination (isatuximab, pomalidomide, and dexamethasone) for myeloma patients who have undergone three prior lines of treatment.
Initially approved for fourth-line patients in England and Wales through the Cancer Drugs Fund in October 2020, Myeloma UK submitted evidence supporting this new appraisal in April 2023. The evidence draws from a Patient Treatment Survey involving 57 IsaPd-treated patients.
The NICE committee meeting is set for December 2023.

Selinexor (Nexpovio®), bortezomib and dexamethasone

NICE is currently assessing the use of selinexor combined with bortezomib and dexamethasone for myeloma patients with one to three prior treatment lines.
Myeloma UK has actively participated in this appraisal, providing evidence on patients’ behalf in September 2023. The NICE committee meeting is scheduled for January 2024.

Selinexor and dexamethasone

NICE is currently evaluating selinexor and dexamethasone for myeloma patients who have undergone a minimum of four prior treatments and are refractory to at least two proteasome inhibitors, two immunomodulatory agents, and an anti-CD38 monoclonal antibody (penta-refractory).
Myeloma UK is involved in this appraisal and submitted evidence on behalf of patients in September 2023. The NICE committee meeting is scheduled for January 2024.

Elranatamab monotherapy

NICE is appraising Elranatamab monotherapy for relapsed or refractory myeloma patients who have received at least three treatments, including an immunomodulatory drug, a proteasome inhibitor and an anti-CD38 monoclonal antibody (triple-class refractory).
Myeloma UK is involved in this appraisal and will submit evidence on behalf of patients in October 2023. The committee meeting is scheduled for March 2024.

Teclistamab monotherapy

NICE appraisal for teclistamab monotherapy is due to start towards the end of 2023.
The appraisal will assess its use for treating relapsed or refractory myeloma patients who have had three or more previous treatments. The scoping consultation is open until 30 October.
Myeloma UK submitted evidence in October 2023. The SMC committee meeting will be scheduled soon.

If you would like more information on HTA processes, upcoming treatment appraisals, or Myeloma UK’s access work, contact the Policy Team.