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Teclistamab Approved for Fourth-Line Myeloma Treatment on NHS in England and Wales

• Teclistamab (Tecvayli) has been approved by NICE for fourth-line treatment of multiple myeloma in England and Wales, offering a new option for patients who have exhausted other treatments. • The approval expands access to teclistamab for patients with triple-class refractory myeloma, following calls from Blood Cancer UK and other charities to broaden its availability. • Teclistamab, a bispecific monoclonal antibody, works by attaching to cancer cells and immune cells, enabling the body's immune system to destroy myeloma cells. • Patients who have received at least three prior treatments, including an immunomodulatory drug, a proteasome inhibitor, and an anti-CD38 antibody, and whose cancer has progressed, are eligible for teclistamab.

The National Institute for Health and Care Excellence (NICE) has recommended teclistamab (Tecvayli), a drug manufactured by Johnson & Johnson, for use on the National Health Service (NHS) in England and Wales as a fourth-line treatment for multiple myeloma. This decision provides a new therapeutic option for patients who have already undergone at least three prior treatments.

Eligibility Criteria

To be eligible for teclistamab, patients must have received prior treatment with:
  • An immunomodulatory drug
  • A proteasome inhibitor
  • An anti-CD38 antibody and experienced disease progression since their last treatment.

Reversal of Previous Restrictions

NICE had previously approved teclistamab with the condition that it would only be available to patients who would have been offered pomalidomide plus dexamethasone. Following appeals from Blood Cancer UK and other organizations, NICE has broadened the availability of teclistamab to all patients with triple-class refractory myeloma.

Mechanism of Action

Teclistamab is a bispecific monoclonal antibody administered via injection. It functions by recognizing and attaching to both cancer cells and immune cells, thereby facilitating the destruction of myeloma cells by the body’s immune system.

Patient Testimonials

Guy Mainwaring, a 63-year-old patient from Cheshire who began receiving teclistamab in January 2023 after multiple prior treatments, shared his experience: "I felt like a switch had been flicked, I got my life back and within a couple of weeks not months, I was starting to feel so much better... It’s so good to meet up with friends, colleagues and family again, chat and be able to look forward to the future with optimism."

Expert Commentary

Josh Hill, Policy Officer from Blood Cancer UK, stated: "While this new drug is only available to those who have already received three prior treatments, it is welcome news that more people in England and Wales with myeloma will be able to access teclistamab... With advances in bispecific treatment approaches set to continue in coming years, it is our hope at Blood Cancer UK that more people will be able to benefit from this class of drugs going forward."

Myeloma Statistics

Myeloma affects plasma cells, a type of white blood cell. While most patients are men over the age of 70, individuals can be diagnosed at a younger age. The condition can be treated but is not currently curable. Approximately 6,200 people are diagnosed with myeloma each year in the UK, making it the fifth most common cancer.
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Reference News

[1]
New life-changing myeloma drug approved for fourth-line use on the NHS for those ...
bloodcancer.org.uk · Oct 10, 2024

Teclistamab (Tecvayli), a Johnson & Johnson drug, is now recommended by NICE for fourth-line use on the NHS in England a...

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