The guidance recommends the use of small molecule Nexpovio (selinexor) in combination with bortezomib and dexamethasone for eligible patients who have undergone 1 or 2 prior treatments.
This recommendation is poised to fill crucial gaps in the treatment pathway, potentially making over a thousand patients eligible for a therapy that could delay cancer progression and extend survival.
Dr. Neil Rabin, consultant hematologist at University College London Hospitals, hailed the decision as a significant advancement in addressing the unmet needs of myeloma patients.
He said: “Being able to use different treatments that work in a variety of ways is critically important to help evade and overcome the cancer’s defense mechanisms. Today’s news has enabled just that and means we now have a new way to treat this complex and challenging blood cancer.”
Multiple myeloma
Multiple myeloma, often referred to as 'myeloma,' remains incurable for the majority of patients, necessitating multiple lines of treatment.
“Despite advances in treatment, most patients relapse and will require multiple lines of treatment. Therefore, it is critical to have as many different treatment options as possible that target the cancer cells in different ways to maximize the possibility of patients responding to treatment, and helping keep the cancer at bay,” says Nelluri Geetha, pharma analyst at GlobalData.
Shelagh McKinlay, director of research and advocacy at Myeloma UK, lauded the decision as a victory for the myeloma community, highlighting Nexpovio's novel mechanism of action, which differs from existing treatments.
“This treatment’s novel mechanism of action means it can help fight myeloma in a completely different way to other currently available treatments. Until we have a cure, it is absolutely vital that all patients are given as many options to tackle their cancer as possible – no matter where they are on their treatment journey,” she says.
Nexpovio functions by restoring the body's anti-cancer defense mechanisms, particularly by blocking the action of exportin 1 (XPO1), a protein found in high amounts in myeloma cells.
Rick Coope, general manager at Menarini Stemline UK, is pleased with the collaboration between the industry, NICE, and the myeloma community.
Improving outcomes for myeloma patients
He said: “We are incredibly proud that in Menarini Stemline’s first engagement with NICE, we have successfully reached an agreement for two appraisals – and three lines of therapy - in such a short period.”
The company says the recommendation of Nexpovio by NICE represents a significant milestone in addressing treatment gaps and improving outcomes for multiple myeloma patients in the UK.
Coope added: “Today’s announcement is a significant development for the myeloma community and shows what is possible with true collaboration between industry, NICE, and the myeloma patient and physician community.”
NICE's recommendation not only highlights its potential to address significant unmet needs in myeloma treatment but also underscores the importance of ongoing collaboration between stakeholders in advancing patient care and access to innovative therapies.
