Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what treatment options are available to patients with multiple myeloma who have become refractory to previous lines of therapy.

For patients who have received previous lines of treatment, the National Institute for Health and Care Excellence (NICE) currently recommends the following subsequent treatments in England:

- Daratumumab with bortezomib and dexamethasone (NICE TA573);

- Carfilzomib (NICE TA 457);

- Bortezomib (NICE TA 129); and

- Ixazomib with lenalidomide and dexamethasone (NICE TA505).

For some patients, stem cell transplantation may also be considered, however, the treatment is very intensive and requires a good level of fitness.