NICE recommends elranatamab for adults with a rare form of blood cancer

The National Institute for Health and Care Excellence (NICE) has recommended the use of elranatamab for adults with multiple myeloma, a cancer that forms in a type of white blood cell called a plasma cell.

According to NICE, it’s estimated just over 700 people in England are eligible to benefit from elranatamab for multiple myeloma that has returned and stopped responding to previous treatments, and who have had at least three lines of other kinds of treatment and whose cancer has worsened since receiving the last treatment.

Multiple myeloma is a difficult to treat, rare and devastating form of cancer which can be debilitating, painful and has substantial impact on quality of life.

There are limited treatment options so I know this drug will be welcomed by patients. This is the latest treatment NICE has recommended for multiple myeloma, with three other drugs also recommended in 2024.

- Helen Knight, director of medicines evaluation at NICE

Recent clinical evidence suggests the drug could increase how long people have before their condition gets worse but further evidence is needed to show that people live longer with the treatment.

What is multiple myeloma?

Myeloma is a type of cancer that develops from plasma cells in the bone marrow and affects around 5,000 people a year in England. It’s sometimes called multiple myeloma because it affects more than one part of your body.

The first line of treatment for multiple myeloma is likely to be a combination of chemotherapy and other targeted drugs or steroids. If the cancer returns, treatment options will be reassessed and are usually a different combination of drugs and steroids, and possibly another stem cell transplant.

How does elranatamab work?

Elranatamab is a targeted therapy given as an injection under the skin, either in the abdomen or thigh.

It works by attaching to specific multiple myeloma cancer cells and the immune system’s T-cells. This brings the cells together to help the immune system destroy the cancer cells. By doing this, elranatamab aims to treat the cancer cells without harming healthy ones.

Currently, the drug is recommended in final draft guidance for use in the Cancer Drugs Fund (CDF) while more evidence is being collected. The CDF is a source of funding for cancer drugs in England and a new approach to have access to the latest and upcoming drugs through managed arrangements with drug company manufacturers.

Elranatamab has been deemed not cost-effective enough to be recommended for routine use in the NHS. Instead, Pfizer and the NHS have agreed on a deal to have a discounted rate while more evidence about the drug is being collected. But if in the future there’s further evidence showing that people live longer with this treatment it could be considered cost effective.

NICE decisions are usually adopted in Wales and Northern Ireland as well as England, so the decision is likely to affect patients in all 3 nations.