NICE approves BPD at second line in world-first
BPD, a cutting-edge treatment that has been shown to stop myeloma in its tracks for more than 32 months on average, has been approved at second line. NHS patients in England and Wales will be the first to have access to this treatment worldwide.
BPD combines belantamab mafodotin (Blenrep®), pomalidomide (Imnovid®) and dexamethasone (BPD) and is aimed at people who have received one previous line of treatment including lenalidomide (Revlimid®).
The decision to recommend BPD is based on the DREAMM-8 clinical trial, which looked at how effective BPD is compared to pomalidomide in combination with bortezomib (Velcade®) and dexamethasone (PVD). In the trial, 71% of people on BPD were still in remission after 12 months, compared to just 51% of patients on PVD.
Myeloma UK played an integral role in bringing forward evidence, data and patient experience to each aspect of the NICE appraisal process, which began long before the first Committee meeting in January 2025. Our evidence highlighted the need for clinical and patient choice, and the convenience and flexibility that this combination, with pomalidomide given as a tablet, offered. Clinicians can now offer BPD or BVD (belantamab mafodotin combined with bortezomib (Velcade®) and dexamethasone, approved in June 2025) at second line, tailoring the treatment to individual patient needs.
Dr Amy Capper, Policy Manager at Myeloma UK, said:
“We’ve been working extremely hard to get BPD approved for over a year now and we’re delighted that the voices of patients and the myeloma community have prevailed.
“BPD has the potential to be life-changing for many and we’ve already heard from people who had never been in remission until they were offered this treatment through clinical trials. BPD is also more convenient and flexible compared to other currently available options and means less time spent in hospital, which we know makes a huge difference to people’s quality of life.
“While we’re delighted it’s being rolled out in England and Wales, this treatment remains unavailable in Scotland. Many patients will feel, and rightly so, the unfairness of being denied a treatment which is accessible on the NHS in other parts of the UK. Healthcare should not come down to a postcode lottery and we’ll keep fighting until everyone who needs it gets access to BPD no matter where they are on their treatment journey, or where they live.”
Paul Duckers, a father-of-one from Haughton, near Stafford, was diagnosed with myeloma in February 2021 and enrolled in a clinical trial for BPD in October 2022.
He went into remission after his very first dose of the “miracle” treatment.
More than three years on, Paul is still doing well and has described BPD as a “Godsend”.
He added:
“I’ve had an extra three years and the side effects have not impacted my life. We’re a close family and my wife has been an absolute rock to me. We used to go on a couple of cruises a year but we can’t anymore because I’m at risk of infection. I have to be more cautious but other than that it’s not stopping me from doing things. I can still go for walks in the countryside. We’re going to a very nice Italian restaurant to celebrate my wife and my grandson’s birthdays – he is turning 26 in February. The treatment is working and the results have been extremely encouraging. Delighted isn’t a strong enough word to describe it.”
Q&A
What is BPD?
BPD is a combination of belantamab mafadotin (Blenrep®), pomalidomide and dexamethasone. Belantamab mafodotin is an antibody-drug conjugate, which specifically targets a protein on the surface of myeloma cells called BCMA. This helps deliver chemotherapy straight to the myeloma cells and flags them for the patients’ immune system to kill.
Who can access BPD?
The treatment is available to myeloma patients who have had one previous line of treatment only (also known as second line) including lenalidomide (Revlimid®).
When will BPD be available on the NHS?
A positive recommendation from NICE means clinicians can start prescribing the treatment to eligible patients. However, it may take some time for the treatment to become available, depending on the treatment itself and the capacity of hospitals to deliver it. The treatment should be made available to patients through the NHS within 90 days of the decision being published.
What about patients living in Scotland and Northern Ireland?
In October 2025, the Scottish Medicines Consortium (SMC) made the decision not to approve BPD at second line. The SMC thought that the pharmaceutical company’s evidence for BPD’s value for money was not strong enough.
In Northern Ireland, the Department for Health makes decisions on which treatments to fund through the NHS. It can follow guidance issued by either the National Institute for Healthcare Excellence (NICE) or the SMC, but usually follows the guidance issued by NICE.
What about eye-related side effects?
Eye-related (ocular) side effects are a known, common complication associated with belantamab mafodotin treatment, which led to low treatment discontinuation (≤9%) in both belantamab mafodotin combination trials (DREAMM-7 and DREAMM-8). The ocular side effects have been found to be resolvable through management in most cases – with extended time between infusions and dose reductions found to be effective for management of the side effect whilst maintaining efficacy of myeloma treatment.
GSK is working with NHSE to support management of eye-related toxicity through a patient-support programme.
