The National Institute for Health and Care Excellence (NICE) has approved a new combination treatment for adults with untreated multiple myeloma who are not able to receive a stem cell transplant. The treatment, called D-VRd, combines four medications: daratumumab, bortezomib, lenalidomide, and dexamethasone. This is the only approved therapy in the UK that is given as an injection under the skin for first-line use in these patients. Multiple myeloma is a type of cancer that affects around 33,000 people in the UK and currently has no cure. It becomes harder to treat with each relapse, so doctors emphasize the importance of effective treatment right after diagnosis, especially for the two-thirds of patients who cannot have a transplant. Caroline Donoghue, Access Manager at Myeloma UK, said: ‘This is wonderful news and a significant achievement for patients who felt disappointed when NICE initially did not approve D-VRd. We worked hard to persuade NICE to reconsider, and we are thrilled they have agreed to make this treatment available on the NHS. Being diagnosed with myeloma is devastating, and newly diagnosed patients deserve as many treatment options as possible from the start. This could mean less time spent in the hospital for patients and their families. We cannot stress enough how important this is for their quality of life. Until we find a cure, it is essential that people with myeloma receive the treatment they need as soon as possible after diagnosis.’ Professor Supratik Basu, a Haematology Consultant at The Royal Wolverhampton NHS Trust and University, added: ‘Bortezomib is a well-known and effective therapy, and adding it to the combination of daratumumab, lenalidomide, and dexamethasone makes a big difference. I was proud to be part of the CEPHEUS trial in Wolverhampton, and I have seen first-hand how crucial it is for patients who cannot have a transplant—the majority of myeloma patients—to have multiple treatment options available right from the beginning.’ NICE’s decision is based on a study called the CEPHEUS trial, which found that 60.9% of patients treated with D-VRd had no detectable cancer cells in their bone marrow after treatment, compared to 39.4% of patients treated with a three-drug combination, after an average follow-up of about 58 months. Nina Pinwill, UK Director of Strategic Access, Pricing and Operations at Johnson & Johnson, said: ‘We are happy that D-VRd is now available on the NHS for eligible patients with multiple myeloma who cannot receive a stem cell transplant. Johnson & Johnson has a long history in myeloma treatment, so we know how important it is for patients to have as many effective first-line treatment options as possible. I would like to thank everyone involved in the approval process for helping to make this positive outcome possible. We hope this news brings relief and encouragement to patients and their loved ones.’