1 Recommendations
1.1 Ixazomib, with lenalidomide and dexamethasone, is recommended as an option for treating multiple myeloma in adults, only if:
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they have had 2 or 3 lines of therapy and
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the company provides ixazomib according to the commercial arrangement.
1.2 This recommendation is not intended to affect treatment with ixazomib that was started in the NHS before this guidance was published. People having treatment outside this recommendation may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.
Why the committee made these recommendations
This appraisal reviews the additional evidence collected as part of the Cancer Drugs Fund managed access agreement for ixazomib with lenalidomide and dexamethasone (ixazomib combination) for treating relapsed or refractory multiple myeloma (NICE technology appraisal guidance 505). The original appraisal recommended ixazomib combination in people who have already had 2 or 3 lines of treatment. The usual treatment for these people is lenalidomide and dexamethasone.
The new evidence includes data from a clinical trial and from people having ixazomib combination in the NHS while it was available in the Cancer Drugs Fund. The evidence suggests that people with multiple myeloma who have ixazomib combination live longer compared with people who have lenalidomide and dexamethasone.
The cost-effectiveness estimates for ixazomib combination are likely to be within what NICE considers an acceptable use of NHS resources, so it is recommended.