what is

WHAT IS Multiple myeloma

Multiple Myeloma is a hematological cancer primarily occurring in the bone marrow. It mainly affects older adults, more commonly men, with a median age of diagnosis of 69 years. Multiple Myeloma is a recurring, multi-stage cancer with a long, demanding treatment journey.

There is no known cure for myeloma, but in recent years the treatments for it have improved dramatically. Many patients may now achieve a stable remission, lasting several years, through a combination of medical treatments and stem-cell transplant.

Even though first-line therapies are effective, they can cause severe and challenging side-effects making it difficult for patients to adhere to their life-saving treatment regimes.


  • 140,000 (approx.) people in the US currently have MM (1)
  • 34,920 (approx.) new cases will occur annually in the US in 2021 (2)
  • 30,000 (approx.) new cases occur annually in France, Germany, Italy, Spain and UK (3)
  • 81,050 is the number of new cases forecast to occur in the US, Japan, France, Germany Spain, Italy and the UK by 2037, an increase of 39.3% (4)

DYNAMIC TREATMENT LANDSCAPE. MM follows a relapsing pattern, where patients go through several lines of treatment – with periods of remission followed by relapses as the cancer cells become resistant to the treatment. Because of this, there is a need for new drugs.  Multiple Myeloma survival rates have been extended in recent years, through new drugs and new combinations of existing ones – including the IMiD class of immunomodulatory drugs, with lenalidomide (commercial name Revlimid®) being a so called back-bone therapy in many of these combinations.


Lenalidomide is an immunomodulatory compound targeting both cancer cells and their microenvironment (6). Patients take Lenalidomide daily as an oral capsule (25mg) for 21 days continuously in a 28-day cycle. Whilst Lenalidomide is undoubtedly effective (5) side effects such as diarrhea, fatigue and nausea are common and can for some patients be so disruptive and uncomfortable that it leads to poor compliance with their life-saving treatment regimen.

(1) NIH, SEER, Multiple Myeloma
(2) American Cancer Society 2021
(3) Datamonitor Healthcare, MM Epidemiology 2018
(4) Global Data Multiple Myeloma Forecasts, 2019
(5) Multiple Myeloma Research Foundation
(6) A review of the history, properties, and use of the immunomodulatory compound lenalidomide Zeldis et al. Ann N Y Acad Sci. 2011 Mar;1222:76-82

controlled release

Controlled release, increased compliance


NEX-20 would replace daily doses of lenalidomide throughout 21 days – with a single monthly injection administered in-clinic.

OVER ONE THIRD OF MM PATIENTS HAVE POOR COMPLIANCE: A recent study of 793 patients showed that 38%, over a third, were considered to have poor adherence to lenalidomide, using the medication possession ratio as a surrogate for adherence. (7)

Over one third of older adults with newly diagnosed MM are considered to have poor adherence to lenalidomide. This highlights the need to further understand factors and devise strategies to support adherence in this patient cohort.

Clinical Lymphoma Myeloma and Leukemia


Today’s oral administration makes it relatively easy for patients struggling with side effects to simply stop taking their required medication. Lenalidomide administered once a month, in-clinic, by syringe, could significantly improve compliance and adherence.

This makes co-payments for patients cheaper, and gives healthcare providers in the US the added incentive that on-site injections result in continuous reimbursement compared to prescribed tablets


(7) Clin Lymphoma Myeloma Leuk. 2020;20(2):98-104