A new generation of treatments is bringing fresh hope to thousands of people living with multiple myeloma in the UK, with several innovative therapies recently approved for NHS use that can significantly extend remission and improve quality of life for patients whose cancer has returned or stopped responding to earlier lines of treatment.
How the new treatments work
The latest wave of drugs attacks myeloma cells in distinct ways, offering clinicians a growing arsenal against a disease that remains incurable. Among the most notable is teclistamab (marketed as Tecvayli®), a bispecific monoclonal antibody that acts as a bridge between the body’s immune T‑cells and myeloma cells. By bringing the two together, it enables the immune system to recognise and destroy the cancer. Teclistamab was initially approved on the NHS in England and Wales with restrictions for patients at the fourth line of treatment and beyond — meaning those whose disease had progressed after at least three previous therapies, including an immunomodulatory drug, a proteasome inhibitor and an anti‑CD38 antibody. Those restrictions were lifted in October 2024, opening access to all patients with triple‑class refractory myeloma. Clinical data show the drug can stop myeloma in its tracks for more than 11 months in some cases.
Another breakthrough is belantamab mafodotin (Blenrep®), described as a “Trojan horse” therapy. It is an antibody‑drug conjugate that targets a protein on the surface of myeloma cells, attaches to them and releases a lethal molecule that destroys them from within. In June 2025 the NHS in England became the first health system anywhere in the world to roll out this treatment, approved for eligible patients whose cancer has progressed after or not responded to first‑line treatment with lenalidomide. It is given in combination with bortezomib and dexamethasone (a regimen known as BVd). Trials have shown that BVd can delay disease progression by an average of three years in broader patient groups, compared with just over a year for commonly used drugs such as daratumumab. The National Institute for Health and Care Excellence (NICE) is now considering widening access to patients who have not previously received lenalidomide.
A third option, isatuximab (Sarclisa®), is another monoclonal antibody that harnesses the immune system. In England and Wales it is already approved in combination with pomalidomide and dexamethasone for patients at third relapse, after three previous lines of therapy. More recently, in September 2025, isatuximab was approved in a combination with bortezomib, lenalidomide and dexamethasone (Isa‑VRd) for adults with newly diagnosed multiple myeloma who cannot undergo a stem cell transplant — a significant shift toward using such therapies earlier in the disease pathway.
The development of oral treatments is also improving patients’ lives by reducing the need for hospital visits. Drugs such as ixazomib, a proteasome inhibitor taken as a pill, have been made available via the Cancer Drugs Fund (CDF) while further data are collected. Emerging therapies continue to be tested: a recent trial presented at the American Society of Clinical Oncology meeting showed that mezigdomide — a drug that degrades proteins vital for cancer cell survival and stimulates the immune system — more than doubled progression‑free survival when incorporated into a triplet therapy for relapsed or refractory myeloma patients.
Understanding multiple myeloma
Multiple myeloma is a type of blood cancer that originates from abnormal plasma cells in the bone marrow. Around 6,200 people in the UK are diagnosed with the disease each year, accounting for about 2% of all new cancer cases. Cancer Research UK projects that number will rise by about 1% between 2024‑2026 and 2038‑2040, reaching approximately 8,300 new cases annually by the end of that period. While most patients are men over 70, the disease can affect younger people; incidence rates are highest in those aged 85 to 89.
Myeloma remains incurable. Around 3,200 people die from it each year in the UK, making it the 17th most common cause of cancer death. Mortality rates have increased significantly since the early 1970s, though they have fallen over the last decade, with projections suggesting a further 2% decrease by 2038‑2040. Survival has improved markedly: about 37.8% of patients now live for ten years or more after diagnosis, based on 2018 data.
Roughly 71% of patients experience symptoms at the point of diagnosis, including poor kidney function, anaemia and bone damage. The disease originates from plasma cells — a type of white blood cell that usually produces antibodies — but in myeloma these cells become cancerous and multiply uncontrollably, crowding out healthy blood cells and causing organ damage.
The patients who stand to benefit
The new treatments are specifically designed for patients with relapsed or refractory multiple myeloma — those whose cancer has either returned after a period of remission or has stopped responding to previous therapies. For these individuals, each successive line of treatment typically offers a shorter window of control, making the arrival of effective new options particularly significant.
Patient advocacy groups such as Myeloma UK and Blood Cancer UK have been instrumental in pushing for access to these therapies, challenging restrictions and supporting patients through the process. Their efforts helped secure the lifting of restrictions on teclistamab and the rollout of belantamab mafodotin. The impact on quality of life can be profound. One patient described teclistamab as a “complete life‑changer”, regaining the ability to exercise and play golf after months of decline. Belantamab mafodotin is expected to provide remissions averaging more than three years, allowing patients valuable time with family and friends.
Access to new treatments in the UK is governed by a rigorous assessment process. NICE in England and Wales, and the Scottish Medicines Consortium (SMC) in Scotland, evaluate both clinical effectiveness and cost‑effectiveness. For drugs that show promise but still carry some clinical uncertainty, the Cancer Drugs Fund provides interim funding while additional data are collected, often paired with managed access agreements that allow price negotiations between pharmaceutical companies and NHS England. Drugs such as ixazomib and isatuximab have entered the system through this route.
Despite the advances, myeloma remains an incurable disease. Researchers and clinicians continue to stress the need for a full cure. Clinical trials remain a vital pathway for patients to access innovative therapies; Myeloma UK’s Clinical Trial Finder helps patients identify opportunities to participate. The progress of recent years, however, marks a step change in what is possible. For the 6,200 people diagnosed each year — and the thousands already living with the disease — the new treatments offer not just more time, but better time.