The New CLL Treatment Landscape


In the above video  Dr. Peter Hillmen shares CLL research highlights from the 2014 European Haematology Association (EHA) meeting in Milan. Dr. Hillmen discusses advances in oral CLL therapies, including ibrutinib (Imbruvica) and developing oral therapies idelalisib and ABT-199.

 

In the above video Dr george Follows discusses how the new targeted therapies will require discipline and engagement by patients to ensure they take their medications to stay in remission. Longer term the research community is working towards novel none chemo combinations that may produce a durable MRD status, removing the need then for continued medication, this could one day translate into a cure.

Q1) What would you say is the CLL patient’s role and responsibility when it comes to their treatment?
Q2) Do you think could ever get to the point where patients can stop taking medicines after treatment?

 

New treatment options’ webcast with slides  Cambridge CLLSA meeting 2014. Latest treatments and clinical trials

 

Read about the UK clinical trials process  and available trials

 

In the video below Dr Follows and CLL Nurse specialist Gwyn Stafford of Cambridge University Hospitals discuss and answer questions from CLL patients & carers.  

The Q&A session focuses on : CLL incidence, clinical trial care, trial inclusion/exclusion criteria, excitement about the new treatment landscape, treatment choice, infection risk, long term side effects, cost of new treatments, monitoring post treatment, coping with CLL, anxiety and depression and more about trials.

An evolving and complicated picture but undoubtedly we are entering an exciting new era of CLL treatment.

 

New treatments available to treat CLL in the UK Nov 2015

With the CLL landscape beginning to change several new treatments have gained 2015 approval for treating CLL through the NHS following recent NICE & SMC  recomendation and England Cancer Drugs Fund listing. 

 

Nov 2015 England Cancer Drug Fund listing for England availability

NHS Coices - Cancer Drugs fund website

PDF download - England Cancer Drugs Fund list (updated November 2015)

NICE publish final guidance for idelalisib to treat CLL, moving England and Wales NHS access closer

NICE publish final guidance  of Idelalisib for treating chronic lymphocytic leukaemia making idlalisib plus rituximab availble to NHS England & Wales. The new treatment offers and option for hard to treat patients living with chronic lymphocytic leukaemia who are untreated and have a 17p deletion or TP53 mutation or for chronic lymphocytic leukaemia  patients that have been treated but have relapsed within 24 months.

NICE technology appraisal guidance [TA359] http://www.nice.org.uk/guidance/TA359

 

Obinutuzumab (Gazyvaro), given with a drug called chlorambucil, is recommended as a possible treatment for adults with untreated chronic lymphocytic leukaemia only if:

they have other conditions that make full-dose fludarabine unsuitable for them and

bendamustine is not suitable for them.

What does this mean for me?

If you have chronic lymphocytic leukaemia, and your doctor thinks that obinutuzumab (with chlorambucil) is the right treatment, you should be able to have the treatment on the NHS. Technology appraisal guidance [TA343] Published today June 2015

You can access full guidance details on the NICE website here:http://www.nice.org.uk/guidance/ta343

 

Technology appraisal guidance [TA344] Published today June 2015

You can access full guidance details on the NICE website here:http://www.nice.org.uk/guidance/ta344

Ofatumumab (Arzerra) given with a drug called chlorambucil is recommended as a possible treatment for people with untreated chronic lymphocytic leukaemia if treatments containing fludarabine or bendamustine are not suitable.

 

The Scottish Medicines Consortium (SMC) approves Obinutuzumab (Gazyvaro®) for use within NHS Scotland.  

Dec 2014 - Indication under review: In combination with Chlorambucil, Obinutuzumab is indicated for the treatment of adult patients with previously untreated chronic lymphocytic leukaemia (CLL) and with comorbidities making them unsuitable for full-dose fludarabine based therapy

Full guidance PDF download

Idelalisib (Zydelig) has been accepted for restricted use by NHS Scotland.

09 March 2015 - P atients with relapsed CLL who are unsuitable for chemotherapy and treatment naïve patients with 17p deletion or TP53 mutation who are unsuitable for chemo-immunotherapy.
You can read the full guidance &  PDF download on the SMC website  

Ofatumumab (Arzerra®) is accepted for restricted use within NHS Scotland.

 

The Scottish Medicines Consortium (SMC) has published advice accepting  Ofatummumab for use in NHS Scotland to treat CLL  Following a full submission assessed under the orphan process

ofatumumab (Arzerra®) is accepted for restricted use within NHS Scotland. 

2016 is set for more change. especially as there many new opportunities planned to come  available through a fast growing list of clinical trials. It is becoming increasingly important to have a consultant with a special interest in CLL on your care team with expert knowledge of these developments and access to latest trials.

With that in mind world expert Dr Claire Dearden of the Royal Marsden delivered us two overview talks at our Brentford members meeting in December after her return from the latest 2014 global conference of haematology clinical researchers  when the latest clinical trial data was disclosed. These webcasts are soon to be available as  video and slides translated and delivered in patient friendly language  for members, to advise and explain what is currently available and how to best live with CLL, with a clear eye on the future changes coming.

Our medical adviser Dr Francesco Forconi a leading clinical researcher based at the Southampton centre of excellence and research has provided us with a review of developments written for CLLSA ahead of the ASH 2014 meeting.

 

 

 The New Landscape in CLL Novel Therapies 

Dr Francesco Forconi (MD, DM, PhD, FRCPath) Associate Professor in Haematological Oncology,  

Cancer Science Unit, University of  Southampton.

Consultant Haematologist - Cancer Care, Haematology Department,  Southampton,  University Hospital Trust.

Read the 2014 article written for CLLSA here