1.1 Lenalidomide is recommended as maintenance treatment after an autologous stem cell transplant for newly diagnosed multiple myeloma in adults, only if:
the dosage schedule is 10 mg per day on days 1 to 21 of a 28‑day cycle and
the company provides lenalidomide according to the commercial arrangement.
1.2 This recommendation is not intended to affect treatment with lenalidomide 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
There is currently no maintenance treatment for newly diagnosed multiple myeloma in people who have had an autologous stem cell transplant. The condition is usually monitored until it gets worse.
Clinical trial results show that, compared with monitoring alone, lenalidomide increases how long people live and extends the time before the condition gets worse.
The most likely cost-effectiveness estimates for lenalidomide compared with monitoring alone are within the range NICE normally considers an acceptable use of NHS resources. Therefore, lenalidomide is recommended.