The NHS in England is leading the world as the first healthcare system to introduce a pioneering ‘trojan horse’ therapy for patients with blood cancer, offering the potential to delay disease progression nearly three times longer than current treatment options.
Belantamab mafodotin, a novel therapy for multiple myeloma—a currently incurable form of bone marrow cancer—has received approval from the National Institute for Health and Care Excellence (NICE) as of 12 June. The treatment could now be offered annually to approximately 1,500 patients across England via the NHS.
The drug is intended for individuals whose cancer has either worsened despite treatment or failed to respond to first-line medication, specifically lenalidomide.
Developed in the UK, belantamab mafodotin belongs to a class of treatments known as antibody-drug conjugates. These therapies are designed to identify and bind to cancer cells, acting as delivery vehicles for potent cytotoxic agents.
Dubbed ‘trojan horses’ by researchers, these drugs are engineered to be absorbed by cancer cells, subsequently releasing a high dose of a toxic compound that destroys the malignant cell from within.
In clinical trials, belantamab mafodotin—when combined with bortezomib and dexamethasone—demonstrated an average delay in disease progression of around three years in a broader cohort of relapsed or treatment-resistant myeloma patients. This contrasts with the roughly one-year delay achieved by the commonly used regimen of daratumumab plus bortezomib and dexamethasone.
Although NICE has not released progression-free survival data for the more narrowly defined group of patients recommended for this treatment, NHS England has already expedited access by including the drug in the Cancer Drugs Fund, making it available from today.
Eligible individuals will receive the treatment through a three-weekly infusion, used in conjunction with bortezomib (administered via injection) and dexamethasone (taken orally).
Paul Silvester, a 60-year-old from Sheffield, was diagnosed with myeloma in July 2023 after the disease led to spinal fractures and a tumour in his back. After standard therapies failed, Paul was enrolled in an early access programme for belantamab mafodotin at the Royal Hallamshire Hospital—and saw his cancer go into remission within weeks.
“I feel like this treatment has brought the party balloons back in the house. It has been amazing – within the first two or three weeks, after the first dose, I was in remission,”
said Paul.“It gives me quite a lot of confidence in the drugs and it makes me more optimistic about the future. I’ve been feeling well and I’m still quite active – that’s what’s important in terms of your quality of life. One of my daughters is graduating from university in October and it’s a goal for me to be there.”
Multiple myeloma is a type of bone marrow cancer that can affect various parts of the skeleton, including the spine, ribs, skull and pelvis. It tends to occur more frequently in men, individuals over the age of 60, those with a family history, and is twice as prevalent in Black populations compared to White or Asian groups.
Although the condition is not curable, treatment typically focuses on suppressing the cancer with minimal side effects for as long as possible. The cyclical nature of relapse can also take a considerable emotional toll on patients.
Each year, more than 6,000 people in the UK receive a multiple myeloma diagnosis, and it is estimated that around 33,000 are currently living with the disease.
Professor Peter Johnson, NHS England’s National Clinical Director for Cancer, said:
“Myeloma is an aggressive type of blood cancer, but we have seen a steady improvement in the outlook for patients over recent years as we have introduced new targeted therapies.
“I am delighted that patients in England will be the first to benefit from this new treatment, which has the potential to keep cancer at bay for years longer, giving people the chance of more precious time with friends and family.
“This treatment could be life-changing for many patients and their families, and that’s why it is so important that the NHS continues to secure quick access to the latest, innovative treatments like this, at affordable prices to the taxpayer.”
Health Minister Karin Smyth commented:
“This groundbreaking therapy puts the NHS at the forefront of cancer innovation. By harnessing cutting-edge ‘trojan horse’ technology, we’re offering new hope to blood cancer patients across the country.
“We’re determined to back scientific breakthroughs that deliver real results for patients – bringing the latest treatments from the lab to those who need them most. It’s another example of how we’re building an NHS fit for the future, one that embraces medical innovation to transform patient care.”
Shelagh McKinlay, Director of Research and Advocacy at the charity Myeloma UK, welcomed the news:
“It’s fantastic to see the UK at the forefront of myeloma treatment. NHS England has demonstrated that it is possible for myeloma patients to have world-first access to innovative drugs.
“We have been working very hard for the last year to get this treatment approved and we know it will transform the lives of thousands of people with myeloma.”
GSK’s Antoine Herbaux, Vice President and Head of Oncology UK, noted:
“We are delighted to have worked with NHS England and NICE on this significant recommendation in helping support unmet need in multiple myeloma.
“Today’s announcement highlights an example of local innovation – Belantamab mafodotin was partly discovered in Stevenage, the first patient to receive it in clinical trials was in London, and now the UK is the first country to grant patient access. This milestone is a great example of the power of scientific innovation and open collaboration to achieve positive outcomes for patients in the UK.”
Patients prescribed the drug will require regular eye checks before treatment begins and after each of their first three doses. Reported side effects include vision problems such as blurred vision, dry eyes, sensitivity to light, and ocular toxicity.
The advent of therapies like belantamab mafodotin has been driven by the UK’s vibrant life sciences sector, supported by the largest concentration of cell and gene therapy companies outside the United States—centred in Stevenage and extending across Oxford, London and Cambridge.
