Bortezomib is recommended as induction treatment in combination with dexamethasone, or with dexamethasone and thalidomide, for previously untreated myeloma patients who are eligible for high-dose chemotherapy and haematopoietic stem cell transplantation.
Bortezomib monotherapy is recommended as an option for myeloma patients who have relapsed after having received one prior treatment and who have undergone, or are not eligible for high-dose chemotherapy and stem cell transplantation.
Lenalidomide in combination with dexamethasone is recommended, within its licensed indication, as an option only for myeloma patients who have received two or more prior treatments on the condition that the drug cost for patients who remain on treatment for more than 26 cycles is met by the manufacturer.
AWMSG has recommended the use of plerixafor (Mozobil®) as an option within NHS Wales in combination with granulocyte-colony stimulating factor (G-CSF) to enhance mobilisation of haematopoietic stem cells in myeloma patients whose cells mobilise poorly. Patients may use plerixafor if they have already failed one complete mobilisation attempt.
AWMSG has recommended the use of bortezomib subcutaneous injections for the treatment of relapsed myeloma patients who have received at least one prior treatment or for use in previously untreated patients who are not eligible for high-dose chemotherapy and stem cell transplantation.
SMC advice on the use of subcutaneous bortezomib injection within NHS Scotland in combination with melphalan and prednisone for the treatment of previously untreated non-transplant eligible myeloma patient or for the treatment of relapsed myeloma patients who have received at least one prior treatment and who have already undergone or are not transplant eligible.
SMC advice for the restricted use of bortezomib in combination with dexamethasone and thalidomide as induction treatment for previously untreated myeloma patients who are transplant eligible.
SMC advice for the restricted use of lenalidomide at first relapse in myeloma patients who have received prior treatment with bortezomib in whom thalidomide has not been tolerated or is contraindicated.
Best practice advice on the care of patients with advanced and progressive disease who require strong opioids for pain control. These patients are defined as those in severe pain who may be opioid-naive, or those whose pain has been inadequately controlled on step two of the WHO pain ladder.
Recommendations on the prevention, identification and management of neutropenic sepsis in cancer patients.
