Photo by Tima Miroshnichenko
A pioneering “Trojan horse” cancer therapy is now available through the NHS in England in a global first, offering new hope to thousands of patients living with the blood cancer myeloma.
The innovative treatment, called belantamab mafodotin, has demonstrated the ability to halt myeloma progression for nearly three times longer than current options. It delivers a potent dose of chemotherapy directly into cancer cells, reducing harmful side effects often associated with traditional treatments.
Among the first patients to benefit is 60-year-old Paul Silvester from Sheffield, who described the therapy as “life-changing.” Diagnosed almost two years ago after myeloma led to fractures in his spine, Paul underwent a bone marrow transplant but relapsed around Christmas. He was then offered belantamab mafodotin through an early access scheme and entered remission within weeks.
“Other treatments would have had me isolating for months,” said Paul. “This gave me a chance to live normally again.” Now planning a visit to Hadrian’s Wall and preparing to watch one of his daughters graduate, he added, “Most people tell me I look really well. I have a good normal life.”
How the Treatment Works
Belantamab mafodotin is a type of antibody-drug conjugate, a sophisticated form of chemotherapy. It combines a toxic chemotherapy agent with an antibody engineered to seek out and bind to plasma cells—the type affected by myeloma. Once attached, the therapy is absorbed into the cancer cells and unleashes its lethal chemical payload from within, mimicking the deceptive tactic of the mythological Trojan horse.
Although myeloma remains incurable, clinical trials revealed the therapy could suppress the disease for around three years—compared to just 13 months using current treatments.
Professor Peter Johnson, NHS England’s national clinical director for cancer, called the development “life-changing.” He emphasized the value of giving patients more time free from symptoms: “Using antibodies to deliver chemotherapy directly into cancer cells can have a huge impact.”
Impact and Scope
About 33,000 people in the UK are currently living with myeloma. With this approval, approximately 1,500 patients annually—those whose cancer has returned or no longer responds to first-line treatments—will gain access to the therapy.
The approval follows a review by the National Institute for Health and Care Excellence (NICE), which deemed the treatment cost-effective for NHS use. While NHS England will roll out the therapy immediately, NICE recommendations typically extend to Wales and Northern Ireland, with Scotland undergoing a separate evaluation process.
Though generally gentler than conventional therapies, belantamab mafodotin is not without side effects. After the drug destroys a cancer cell, residual chemotherapy agents can escape into the bloodstream, sometimes causing dry eyes or blurred vision.
Advancing Cancer Treatment
Developed by UK-based pharmaceutical company GSK, early research on belantamab mafodotin began in Stevenage, with initial clinical trials taking place in London. The treatment is part of a growing class of antibody-drug conjugates—drugs designed to target specific cancers while sparing healthy tissue.
“These are very smart drugs,” said Professor Martin Kaiser, a specialist in myeloma molecular therapy at the Institute of Cancer Research. He noted the reduced side effects as a significant advantage and suggested that long-term remission for myeloma patients could exceed 50% within five years.
The technology is already being adapted to treat other cancers, including certain types of breast, stomach, and bowel cancers, though its effectiveness depends on identifying unique markers that distinguish cancerous cells from healthy ones.
Shelagh McKinlay of the charity Myeloma UK hailed the move as a “transformational” breakthrough for patients. “It’s fantastic to see the UK at the forefront of myeloma treatment,” she said.
Health Minister Karin Smyth echoed the sentiment, calling the drug’s approval a major milestone: “This ground-breaking therapy puts the NHS at the forefront of cancer innovation.”
