Pfizer’s Elrexfio (elranatamab) has been recommended with managed access by the National Institute for Health and Care Excellence (NICE) to treat relapsed and refractory multiple myeloma in adults.
The BCMA-directed bispecific antibody will now be available for use on the NHS in England via the Cancer Drugs Fund (CDF) while more evidence is collected about its effectiveness.
Patients eligible for the drug will have received at least three lines of treatment, including an immunomodulatory drug, a proteasome inhibitor and an anti-CD38 antibody, and will have experienced disease progression on the last therapy.
NICE’s final draft guidance, which comes less than two months after the Scottish Medicines Consortium accepted Elrexfio for use in the same patient population, was supported by positive results from the mid-stage MagnetisMM-3 study.
After more than two years of follow-up, the objective response rate for patients on Elrexfio was 61%. Patients also demonstrated a median overall survival of 24.6 months, with a median progression-free survival of 17.2 months.
Affecting approximately 5,000 people every year in England, multiple myeloma is an incurable cancer that develops from plasma cells in the bone marrow. The disease often affects several areas of the body and follows a relapsing-remitting pattern, meaning it usually returns after a period of remission and further treatment is required.
Elrexfio is given as a subcutaneous injection and is designed to help the immune system recognise and kill cancer cells by binding to both BCMA, which is highly expressed in multiple myeloma, and CD3 receptors found on the surface of T cells. NICE estimates that just over 700 people in England are now eligible for the drug.
The health technology assessment agency previously recommended Elrexfio in draft guidance, published in July, in which the drug was only recommended if pomalidomide plus dexamethasone would otherwise be offered
Commenting on the latest decision, Ruhe Chowdhury, oncology medical director at Pfizer UK, said: “We are pleased that NICE has reviewed its earlier position and taken the decision to recommend [Elrexfio] without the pomalidomide plus dexamethasone restriction, meaning that more patients will now be able to access the treatment via the NHS rather than just a select few.
“This is important considering the relapsing and remitting nature of the disease and the fact that patients continue to need additional options, especially as their cancer advances and stops responding to earlier lines of therapy.”