The National Institute for Health and Care Excellence (NICE) has recommended Menarini Stemline UK’s Nexpovio (selinexor) as part of a combination treatment for multiple myeloma patients who have received one to two prior treatments.
The agency has specifically recommended the drug for use alongside bortezomib and dexamethasone in patients who have had one previous line of treatment and who are refractory to both daratumumab and lenalidomide or who have had two previous lines of treatment and are refractory to lenalidomide.
The new final draft guidance builds on NICE’s previous recommendation of Nexpovio in combination with dexamethasone to treat myeloma patients whose disease has progressed after four or more prior treatments and who are refractory to at least two proteasome inhibitors, two immunomodulatory agents and an anti-CD38 monoclonal antibody.
The company said the recommendations “address significant gaps at three critical points in the treatment pathway” and mean that hundreds of patients could now be eligible for a treatment “that has the potential to delay the progression of this cancer and prolong survival”.
Multiple myeloma is one of the most common forms of blood cancer in the UK, with over 4,500 new patients diagnosed every year. The disease remains incurable in the majority of cases despite advances in treatment, with most patients relapsing and requiring multiple lines of treatment.
“Being able to use different treatments that work in a variety of ways is critically important to help evade and overcome the cancer’s defence mechanisms,” said Dr Neil Rabin, consultant haematologist at University College London Hospitals. “[This] news has enabled just that and means we now have a new way to treat this complex and challenging blood cancer.”
Nexpovio works by blocking the action of the exportin 1 protein, which is found in high amounts in myeloma cells and, when left unchecked, takes essential tumour-prevention proteins out of the nucleus, where they have little effect.
Rick Coope, general manager at Menarini Stemline UK, said: “[The] 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.”
Coope added that the company is now focused on “obtaining equal access to Nexpovio across the UK and progressing research to bring further innovation to patients with haematological and oncological conditions”.