PIONEERING ORAL TREATMENT GREENLIT FOR MYELOMA PATIENTS

PIONEERING ORAL TREATMENT GREENLIT FOR MYELOMA PATIENTS  

A ground-breaking oral treatment that could increase survival by 10 months has been given the green light for patients with incurable blood cancer in England and Wales.  

The National Institute for Health and Care Excellence (NICE) has approved the use of ixazomib (Ninlaro®) in combination with lenalidomide (Revlimid®) and dexamethasone (IRD) – the first oral triplet treatment for myeloma, an incurable blood cancer which kills 3,000 people in the UK each year. 

IRD is aimed at patients whose cancer has returned for a second or third time and has been shown to increase average survival by 10 months. 

The treatment has also been shown to increase remission times by nine months on average. 

Unlike standard myeloma treatments, this game-changing new drug combination can be taken at home, saving vulnerable patients from exhausting and, in the wake of the cost-of-living crisis, potentially expensive weekly trips to the hospital for treatment. 

Around 1,000 patients could benefit from this at-home treatment each year. 

Shelagh McKinlay, director of research and advocacy at blood cancer charity Myeloma UK, said: “IRD is a game-changer and we’re absolutely delighted with NICE’s decision. We know that over time people become resistant to specific drugs, so it is absolutely crucial to constantly develop new treatment options and to add yet more weapons to patients’ armoury. 

“As the first oral triplet treatment for myeloma, IRD is truly paving the way for more patient-friendly treatments. 

“Not only does it increase average survival by 10 months and extend remission by an average of nine months, but it gives patients something they could only have dreamed of just a few years ago: a life that doesn’t revolve around weekly hospital appointments. And as the cost-of-living crisis bites, the heavy financial burden of constantly travelling to and from the hospital can’t be underestimated.  

“But while patients in some parts of the country now benefit from a treatment that could make a marked difference to their day-to-day lives, others in Scotland have no such luck. Healthcare should not come down to a postcode lottery and we won’t rest until everyone has access to the latest, most effective and patient-friendly treatments – no matter where they live in the UK.” 

Myeloma is an incurable blood cancer which affects 24,000 people in the UK. 

It is a relapsing-remitting cancer, meaning that although many patients will experience periods of remission following treatment, the disease will inevitably return. 

Around 5,800 people are diagnosed with myeloma in the UK each year.  

Half of myeloma patients survive their disease for five years or more. 

Only around a third of myeloma patients survive for ten years or more. 

Ixazomib is a proteasome-inhibitor drug. It works by blocking proteasomes – large molecules found in all cells of the body – from breaking down unwanted proteins.

Myeloma cells rely more heavily on proteasomes, as they produce more proteins than normal healthy cells. They are therefore much more sensitive to ixazomib. 

The triplet treatment was initially rolled out in 2017 through the Cancer Drugs Fund – a pot of money which provides cancer patients in England with faster access to the most promising new drugs pending full approval from NICE.  

Overtime, IRD has become the standard for patients on their third or fourth round of treatment. 

John Ellwood, a retired headteacher from West Oxfordshire, was among the first patients to receive IRD when his cancer returned for the third time. He has been in remission ever since. 

John was just 58 when, in 2011, he was diagnosed with MGUS, a benign condition which had just a one per cent chance of developing into a cancer like myeloma. A year later, he was told the condition had progressed to myeloma. 

“I am so glad ixazomib in combination with lenalidomide and dexamethasone has been approved by NICE,” said the 69-year-old. “To be able to take an effective drug with minimal side-effects at home as part of your treatment is hugely beneficial – no weekly trips to the hospital, no car parking hassles, no long hours attached to a drip! This makes a significant psychological as well as a physical contribution to the treatment of myeloma. I’m pretty much living a normal life now.” 

At the peak of the pandemic, the handy at-home treatment was made available to patients much earlier in their treatment journey to help reduce hospital appointments as much as possible. 

Prof Graham Jackson, consultant haematologist at Newcastle Hospitals NHS Foundation Trust and professor of clinical haematology at Newcastle University, said: “It is fantastic news for myeloma patients that NICE have approved IRD therapy. This is an important triplet therapy giving an average of nine months longer in remission and effective in both low- and higher-risk disease.

“It is the only triplet therapy that is all oral, meaning patients have to spend less time in hospital receiving treatment. This regime has been widely used through the Cancer Drugs Fund and has been extensively used during the COVID-19 pandemic as NHS England recognised the value to both the NHS and the patient of an effective oral therapy for myeloma patients.” 

For more information about myeloma or to get in touch with Myeloma UK go to www.myeloma.org.uk. Myeloma UK runs an Infoline on 0800 980 3332.