NICE recommends belantamab mafodotin for relapsed multiple myeloma, enabling NHS access for 1,600 patients annually with a targeted antibody-drug approach.
Written By: Mahathi Palivela, PharmD
Reviewed By: Pharmacally Editorial Team
The National Institute for Health and Care Excellence (NICE) has issued final draft guidance recommending belantamab mafodotin (Blenrep), a therapy developed by GlaxoSmithKline, for use in patients with relapsed multiple myeloma. The decision enables immediate access through the National Health Service (NHS) in England via interim funding from the Cancer Drugs Fund.
Approximately 1,600 patients annually are expected to benefit from this expanded treatment option.
Disease Burden and Unmet Need
Multiple myeloma is a cancer of plasma cells in the bone marrow. While treatable, it remains incurable and is characterized by repeated cycles of remission and relapse. These relapses often become progressively harder to manage.
Patient testimony presented to NICE highlighted the substantial physical and psychological burden of the disease. Symptoms and complications can significantly reduce quality of life, while the persistent risk of relapse adds ongoing stress for patients and caregivers.
A Targeted ‘Trojan Horse’ Approach
Belantamab mafodotin represents a different therapeutic strategy compared with conventional treatments. It is an antibody-drug conjugate designed to deliver a cytotoxic agent directly into cancer cells.
This “trojan horse” mechanism uses an antibody to bind specifically to myeloma cells, allowing targeted delivery of the drug while limiting broader systemic exposure. The therapy is administered in combination with the established agents bortezomib and dexamethasone.
This targeted approach is particularly relevant for patients whose disease no longer responds to standard therapies or who cannot tolerate them.
Clinical Evidence and Comparative Outcomes
Clinical trial data reviewed by NICE indicate that the combination of belantamab mafodotin with bortezomib and dexamethasone extends progression-free survival compared with a commonly used regimen of daratumumab, bortezomib, and dexamethasone.
Early findings also suggest a potential overall survival benefit, although trials are ongoing and uncertainty remains around long-term outcomes.
Broader Eligibility Criteria
NICE has expanded its initial recommendation criteria. The earlier draft limited use to patients previously treated with lenalidomide who were refractory or intolerant to it. The updated guidance now includes all patients who have received at least one prior line of therapy, regardless of prior lenalidomide exposure.
This change increases the number of eligible patients who can access the therapy.
Stakeholder Perspectives
Helen Knight, director of medicines evaluation at NICE, emphasized that the therapy provides an important additional option for managing a complex and relapsing disease, particularly for patients with limited alternatives.
Myeloma UK welcomed the decision. Dr Scott Purdon noted that clinical trials have shown remission periods exceeding three years on average. He highlighted the significance of extended remission in allowing patients more time with family and improved quality of life, while underscoring the importance of continued access to innovative treatments.
Next Steps
Final NICE guidance is expected later this month. In the interim, patients in England will be able to access belantamab mafodotin through the Cancer Drugs Fund, ensuring no delay in availability following the draft recommendation.
References
‘Trojan horse’ treatment recommended for people with multiple myeloma | NICE
About the Writer
Mahathi Palivela is pursuing PharmD and has a strong interest in Clinical Pharmacy and Patient safety. She is passionate about handling and analyzing patient data, and translating clinical insights into clear, meaningful summaries. She aims to apply this interest in Medical Writing and Pharmacovigilance, focusing on improving patient outcomes through careful data interpretation and communication.