NHS First in the World to Roll Out “Trojan Horse” Drug for Blood Cancer

Introduction

In a global first, the NHS is offering belantamab mafodotin as a routine treatment for multiple myeloma patients who have not responded to other therapies. The drug works by targeting a protein found on the surface of cancerous plasma cells and delivering a toxic payload that destroys them from within. NICE approved its use following an assessment of clinical and cost effectiveness.

Clinical Benefits

Belantamab mafodotin has been shown to delay disease progression by up to two years longer than existing treatment options. In combination with bortezomib and dexamethasone, it significantly improves outcomes in patients whose disease has returned after prior treatment. Administered as an intravenous infusion every three weeks, the therapy offers new hope to individuals with limited alternatives.

Patients enrolled in early access programmes reported life-extending benefits and rapid improvement in symptoms. One patient described the drug as “a miracle” after other treatments had failed to stop the cancer from progressing.

Mechanism of Action

Belantamab mafodotin is an antibody-drug conjugate. It binds to B-cell maturation antigen (BCMA) on malignant plasma cells and delivers a cytotoxic agent directly into the cell. This approach is often referred to as a “Trojan horse” strategy because the cancer cell absorbs the therapeutic agent unaware of its lethal payload. The precision of the treatment helps minimise damage to healthy tissue.

NHS Access and Impact

The NHS negotiated a confidential commercial agreement with the manufacturer to ensure rapid access to the treatment without exceeding budget constraints. It is estimated that around 1,500 patients a year in England will be eligible. NICE concluded that the benefits of extended progression-free survival and manageable side effects justified routine NHS funding.

The introduction of this therapy also reduces the need for more intensive treatments, helping to ease pressure on inpatient oncology services.

Next Steps

Clinicians can begin offering belantamab mafodotin immediately to eligible patients with relapsed or refractory multiple myeloma. NHS trusts should update treatment protocols, confirm access pathways and ensure multidisciplinary teams are aware of eligibility criteria. Ongoing data collection will support continued evaluation of long-term outcomes.

Citation:
National Health Service England. (2025, 13 June). NHS first in world to roll out new ‘Trojan horse’ therapy for blood cancer patients. Retrieved from https://www.england.nhs.uk/2025/06/nhs-first-in-world-to-roll-out-new-trojan-horse-therapy-for-blood-cancer-patients/