1.1 Daratumumab plus bortezomib, thalidomide and dexamethasone is recommended, within its marketing authorisation, as induction and consolidation treatment for untreated multiple myeloma in adults, when an autologous stem cell transplant is suitable. It is recommended only if the company provides daratumumab according to the commercial arrangement.
Why the committee made these recommendations
Before having an autologous stem cell transplant, most people with untreated multiple myeloma have bortezomib plus thalidomide and dexamethasone as the first treatment. This appraisal looks at adding daratumumab to bortezomib plus thalidomide and dexamethasone (daratumumab in combination) before transplant (induction) and for a short time after transplant (consolidation).
Clinical trial results show that, compared with bortezomib plus thalidomide and dexamethasone, daratumumab in combination increases how long people live and extends the time before the condition worsens.
The cost-effectiveness estimates are within what NICE considers acceptable. So, daratumumab in combination is recommended.