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Carfilzomib with dexamethasone and lenalidomide for previously treated multiple myeloma

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1 Recommendations

1.1 Carfilzomib with lenalidomide and dexamethasone is not recommended, within its marketing authorisation, for previously treated multiple myeloma in adults.

1.2 This recommendation is not intended to affect treatment with carfilzomib with lenalidomide and dexamethasone 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

Clinical trial evidence shows that carfilzomib with lenalidomide and dexamethasone gives longer periods of remission and people live longer than with lenalidomide and dexamethasone. It also suggests that people live longer than 24 months.

However, there is uncertainty about how long the benefit lasts after stopping treatment. This makes the cost-effectiveness estimates uncertain. The most likely cost-effectiveness estimate is higher than what NICE normally considers a cost-effective use of NHS resources. So, carfilzomib with lenalidomide and dexamethasone is not recommended for routine use in the NHS.

Collecting more data is not likely to resolve the uncertainty. So carfilzomib with lenalidomide and dexamethasone cannot be recommended for use within the Cancer Drugs Fund.