The National Institute for Health and Care Excellence (NICE) decision to back the use of Janssen’s Velcade (bortezomib) in newly-diagnosed multiple myeloma has been hailed as “fantastic news” by the charity Myeloma UK.
Newly-diagnosed patients will now be guaranteed access to Velcade before bone marrow transplant, after evidence presented to NICE’s independent appraisal committee showed that having the drug at this stage will help more patients go on to a bone marrow transplant, and consequently prevent the disease from progressing for longer, said Professor Carole Longson, director of NICE’s centre for health technology evaluation.
Almost 4,000 cases of multiple myeloma are diagnosed every year in the UK and there is currently no cure, only treatments to stop its progress and relieve symptoms. Stem cell transplantation is the gold-standard treatment for the condition because it is associated with improved survival, and the aim of induction therapy is to enable more people to have stem cell transplantation successfully, says NICE.
The current standard induction therapy in the UK is the combination of cyclophosphamide, thalidomide and dexamethasone.
The Institute’s independent experts looked at Velcade’s use in combination with drugs that help to stop the progress of the myeloma – the steroid dexamethasone, or dexamathasone and thalidomide.
Welcoming NICE’s recommendation, Myeloma UK chief executive Eric Low said it means that clinicians can now chose between at least three options in the induction setting, enabling them to tailor treatment to best suit the clinical situation at hand and also to reflect patient preference.
“We hope that commissioners in England and Wales will make Velcade induction available to patients immediately,” he added.
Professor Peter Johnson, chief clinician at Cancer Research UK, also said the decision was “very welcome.”
“Modern treatments have steadily improved the outlook for patients with this illness, and this decision will help more people reach a point where they can have a bone marrow transplant, one of the best treatments we have for improving survival,” said Prof Johnson.
- Last November, NICE issued a preliminary rejection of first-line use of Velcade in certain patients with newly-diagnosed multiple myeloma, after uncertainties in the data led an independent appraisal committee to conclude that its cost per Quality-Adjusted Life Year (QALY) would likely “substantially” exceed £39,000, and asked Janssen to provide further evidence on its use with dexamethasone and thalidomide.
Then in March, it announced that it planned to reverse this negative decision.
NICE already recommends Velcade monotherapy as an option for the treatment of progressive multiple myeloma in people who are at first relapse having received one prior therapy and who have undergone, or are unsuitable for, bone marrow transplantation.