Bortezomib and thalidomide for the first‑line treatment of multiple myeloma

NICE technology appraisals [TA228] Published date:

NICE recommends bortezomib and thalidomide as possible first treatments for some people with multiple myeloma (see below).

Who can have bortezomib and thalidomide?

You should be able to have thalidomide if:

  • it’s given with a type of drug called an alkylating agent (for example, melphalan) and a type of drug called a corticosteroid (for example, prednisolone) and
  • intensive drug treatment together with a stem cell transplant is not suitable for you.

You should be able to have bortezomib if:

  • you would normally be offered thalidomide but you cannot take it because of side effects or other reasons.

Why has NICE said this?

NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS.

NICE recommended thalidomide because it works better than other treatments available on the NHS (such as melphalan with prednisolone). Although its use costs more than these other treatments, this was justified by the benefits it provided.

NICE recommended that bortezomib should only be offered to people who cannot take thalidomide. This is because although bortezomib works as well as thalidomide it costs more.

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