20 December 2017

Combining two targeted drugs is showing huge promise for treating chronic lymphocytic leukaemia (CLL), early research has suggested.

Of 38 patients who completed six months of a trial in which they were prescribed two targeted drugs, venetoclax and ibrutinib, almost half are in complete remission.

The six-month response rates to the trial, which is part in the CLARITY study, exceeded what doctors had expected to see after a year of treatment, delegates to the annual meeting of the American Society of Hematology in Atlanta, Georgia, USA, heard.

The trial is taking place at UK hospitals involved in the Bloodwise Trials Acceleration Programme network.

It recruited 50 people with CLL who had either relapsed or had not responded to previous treatment and they were given both venetoclax, which switches off proteins on cancer cells that help keep the cells alive, and ibrutinib, which targets and switches off a protein linked to cell growth and movement in the cancer cells.

Delegates heard that 49 patients have begun the drug combination treatment and 38 patients have reached six months of combination treatment. Every patient who has completed six months has responded to the drug combination, and almost a half of these patients are in complete remission.

Three in ten patients had no detectable sign of minimal residual disease (MRD) in their bone marrow or blood after six months of treatment.

Professor Peter Hillmen, who is running the trial at the Leeds Cancer Centre, UK, said: “These early results show that combining ibrutinib with venetoclax could offer an effective alternative to chemotherapy, which has its limitations.

“The drug combination resulted in a significant proportion of patients going into remission after a short amount of time, offering the possibility of stopping therapy after a relatively short treatment period.

“The response rates we have seen in patients after just six months of treatment have far exceeded what we would have expected, so these results are really encouraging.”

Dr Alasdair Rankin, director of research at the charity Bloodwise, which has helped to fund the research, said: “A number of exciting new drugs are becoming available for people with CLL but these treatments will not work in all cases and response rates can vary. The key is determining the right drugs for the right patients and in the right combinations.

“Further monitoring time will be needed to show if these highly promising early response rates to venetoclax and ibrutinib can lead to long lasting remission in patients. It is vital that we continue to look for new ways to improve outcome and extend survival times, particularly for those who have stopped responding to their treatment.”

The positive early results from the CLARITY trial mean that the researchers will test the effectiveness of the ibrutinib and venetoclax combination against conventional chemotherapy or ibrutinib alone in a clinical trial for people with CLL who have not previously received any prior treatment.

Source: Initial Results of Ibrutinib Plus Venetoclax in Relapsed, Refractory CLL (Bloodwise TAP CLARITY Study): High Rates of Overall Response, Complete Remission and MRD Eradication after 6 Months of Combination Therapy, was presented at the Annual Meeting of the American Society of Hematology


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