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NICE issues guidance on bortezomib for induction therapy prior to high dose chemotherapy (HDT) and autologous stem cell transplantation (ASCT) for the treatment of multiple myeloma

Published: 28 April 2014

The National Institute for Health and Care Excellence (NICE) has issued guidance to the health service on the use of bortezomib for the treatment of multiple myeloma, based on a report produced by SHTAC.

NICE has issued guidance to the health service in England recommending the use of bortezomib (given with a drug called dexamethasone, or with dexamethasone and thalidomide) as a possible treatment for adults with multiple myeloma before having chemotherapy and stem cell transplantation, if their multiple myeloma has not been treated before.

NICE's guidance is based on an evidence review group report prepared by SHTAC, which critically appraised the drug manufacturer's submission to NICE's Single Technology Appraisal process.

Multiple myeloma is a form of cancer that arises from plasma cells (a type of white blood cell) in the bone marrow. Myeloma cells produce large quantities of an abnormal antibody that is not able to fight infection, and a build up of these cells interferes with the production of normal blood cells. They also have the ability to spread throughout the bone marrow and into the bone. The term multiple myeloma refers to the presence of more than one site of affected bone at the time of diagnosis. People with multiple myeloma can experience bone fractures, tiredness (due to anaemia), infections, hypercalcaemia (too much calcium in the blood) and kidney problems. Although multiple myeloma is an incurable disease, it can be treated with the aim of extending both the length and quality of life.

Bortezomib is an anti-cancer drug that kills the myeloma cells and reduces tumour growth. It is currently used for multiple myeloma patients who are not eligible for intensive induction therapy and for patients who have received prior treatment.

For more information on SHTAC's research into cancer please visit our Research page.

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