Cancer Medicines Outcomes Programme Public Health Scotland (CMOP-PHS) report
Pomalidomide with dexamethasone after lenalidomide for Multiple Myeloma

About this release

This release by Public Health Scotland (PHS) uses information from the National SACT dataset.

The request made by NCMAG was on the use of: (i) pomalidomide in combination with dexamethasone for treatment of multiple myeloma who have received at least one prior treatment regimen including lenalidomide; and (ii) pomalidomide in combination with bortezomib and dexamethasone for treatment of multiple myeloma who have received at least one prior treatment regimen including lenalidomide. However, due to low patient numbers, the latter was not possible. Therefore, the aim of this work was to capture real-world evidence from Scotland on the use of pomalidomide in combination with dexamethasone for treatment of multiple myeloma after one prior first line treatment that contained lenalidomide.

The objectives were to:

• Describe the baseline characteristics of patients receiving pomalidomide with dexamethasone for multiple myeloma after one prior first line treatment that contained lenalidomide
• Describe treatment characteristics including mean and median duration of treatment
• Provide information on treatment pathways including prior and subsequent systemic anti-cancer therapy (SACT)
• Estimate overall survival (OS) from the start of pomalidomide with dexamethasone treatment

Main points

• This report provides descriptive information on the 20 patients prescribed pomalidomide with dexamethasone for multiple myeloma from 1st January 2018 to 30th June 2024 in clinical practice after one prior first line treatment that contained lenalidomide.
• The estimated median overall survival (mOS) for patients who received pomalidomide with dexamethasone for multiple myeloma was 12 months (95%CI 10.1 - 41.7). At the time of the censor date (31st August 2024), 16 (80%) patients had died.
• The median treatment duration was 5.6 months (Interquartile Range (IQR) 1.9 - 10.4).

Background

Cancer Medicines Outcome Programme (CMOP) Background

The overall vision of the Cancer Medicines Outcomes Programme - Public Health Scotland (CMOP-PHS) collaboration is to better understand the real-life impact of cancer medicines on cancer patients in Scotland. Healthcare professionals may then use these findings to help support clinical decision making and enable a more bespoke and individualised approach to the provision of cancer care for all our patients. Developing, and refining, a robust and reliable process means that cancer medicines intelligence may be routinely generated to support informed decision making at individual, local, and national levels.

Together with information available from clinical trials, this additional knowledge is intended to help NHS Scotland deliver a more personalised approach to providing cancer care, and to help ensure the safe and effective use of medicines.

The CMOP-PHS collaboration builds on established clinical engagement across NHS Scotland Health Boards and integrates with key stakeholders, thereby bringing together clinical, academic and data analysis skills from the NHS, Public Health Scotland, and academia, alongside the patient and public voice. The collaboration provides organisational memory and supports workforce resilience, embedding robust processes to routinely generate and report real-world evidence (RWE). This supports the provision of patient-centred cancer care and decision-making processes, setting Scotland apart as a centre of excellence in the cancer medicines RWE arena

National Cancer Medicines Advisory Group

The National Cancer Medicines Advisory Group (NCMAG) programme is a Health Technology Assessment (HTA) programme which provides advice to NHS Scotland on the clinical effectiveness and value for money of cancer medicines uses.

Cancer medicines that are used ‘off-label’ and 'on-label' uses of generic and biosimilar medicines (also known as ‘off-patent’) are outside the remit of Scottish Medicines Consortium (SMC). NCMAG considers requests for uses of these cancer medicines on a national basis. Across NHS Scotland this means: greater efficiency; standardisation in decision making through a ‘Once for Scotland’ process; consistent patient access to beneficial cancer medicines; improved value for money.

NCMAG published their advice on the use of pomalidomide in combination with dexamethasone for treatment of multiple myeloma after one prior first line treatment that contained lenalidomide on 16th January 2025