CURE looks back on some of the most important stories in the chronic lymphocytic leukemia space from 2023.
In honor of September being blood cancer awareness month, we took a look at five noteworthy stories in the chronic lymphocytic leukemia (CLL) space from 2023.
A promising treatment approach for CLL was evaluated in a recent study. Combining Venclexta with Gazyva has shown significant benefits, including inducing minimal residual disease (MRD) negativity, and improved survival rates for CLL patients. This combination therapy represents a positive development in CLL treatment.
The study focused on patients who were assigned chemotherapy, Venclexta plus Rituxan or Venclexta plus Gazyva and Imbruvica.
“Data from this trial confirm the superiority of (Venclexta)-(Gazyva) over even more potent chemoimmunotherapy regimens than chlorambucil (Leukeran)-(Gazyva) and are leading to the approval of (Venclexta)-(Gazyva) for CLL,” the study authors wrote.
A triplet therapy approach may not offer additional benefits for older patients with CLL.
“Our study demonstrates that the triple therapy — or adding (Venclexta) to (Imbruvica) and (Gazyva) as a course of treatment for older patients with CLL — is not superior in terms of progression-free survival,” Dr. Jennifer Woyach, co-leader of the by The Ohio State University Comprehensive Cancer Center – James Leukemia Research Program and the study’s lead investigator, said in a press release from her institution.
Patients within the study were either assigned triple therapy or Imbruvica and Gazyva. Progression-free survival (the time from when patients were assigned a treatment until disease progression or death) was prioritized within the study.
The findings within the study showed the importance of pairing CLL treatments to individual patient needs, considering factors like age and overall health.
Patients with inactive early-stage CLL have been told to use a different approach called the “wait and watch” strategy in comparison to treatment with Imbruvica, shown in a recent trial.
Findings revealed that Imbruvica improved event-free survival (time to symptomatic progression, CLL treatment or death) within patients.
“(Event-free survival), (progression-free survival) and (time to next treatment) were significantly longer for patients in the (Imbruvica) group,” said Langerbeins, of the division of hematology, immunology, infectiology, intensive care and oncology at the University of Cologne in Germany. “But (Imbruvica) did not prolong survival as compared with placebo.”
The importance of regular monitoring to track the disease's progression and determine when treatment may be necessary, allows for a more individualized treatment for patients with CLL.
The article discusses an impactful treatment, Bruton tyrosine kinase inhibitors (BTK),that changed the space for patients with small lymphocytic lymphoma (SLL) and CLL.
This treatment has given hope to patients who have relapsed or are resistant to other therapies, by producing improved outcomes and efficiency in patients.
Imbruvica became the first FDA-approved BTK inhibitors.
“Imbruvica made an incredible impact for patients with CLL,” says Dr. Ian W. Flinn, director of lymphoma research for the Sarah Cannon Research Institute at Tennessee Oncology in Nashville. “People very sick with CLL who received this treatment oftentimes had near-complete resolution of their symptoms, including severe fatigue, fever and night sweats. They were able to enjoy life again.”
Experts discuss the benefits and recent information of the recent FDA approval of Brukinsa for patients with chronic lymphocytic leukemia and small lymphocytic leukemia. This was an upgrade from Imbruvica, which was shown in a trial to be less safe and efficient.
“(Brukinsa) is a highly effective and safer alternative to (Imbruvica) so its availability is an important step forward for these patients,” Dr. Jennifer R. Brown, lead investigator on the ALPINE trial (one of the two studies that led to Brukinsa’s approval) and director of the CLL Center at the Dana-Farber Cancer Institute in Boston, said in an interview with CURE®. “Many of my patients on this drug say that they don’t even know they are on anything, yet their disease responds well.”
Although Brukinsa has shown more iprovements than Imbruvica, the article sheds light on the fact that while Brukinsa represents a positive step forward, it is not a cure for CLL and SLL.
“Right now, we still give (Brukinsa) continuously, indefinitely. It would be great if we could get patients in remissions that do not require them to remain on therapy,” Brown said.
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