09 August 2018

Leukaemia patients who relapse could be spared repeat chemotherapy treatment in future following a review of medical evidence by NHS England.

Under updated guidance announced today (https://www.england.nhs.uk/wp-content/uploads/2018/08/letter-ibrutinib-cll-response-for-release-aug-2018.pdf, people with chronic lymphocytic leukaemia (CLL) who relapse after more than three years can now be treated with a drug called ibrutinib instead of with chemotherapy.

Up until now, ibrutinib was only made available if patients had relapsed less than three years after chemotherapy. If remission had lasted for longer than three years, it was considered that patients should undergo further chemotherapy, even if their doctors judged that ibrutinib would be more beneficial.

Restricting the use of ibrutinib only to people who had relapsed within three years drew strong criticism from patients and doctors as it appeared to be an NHS England reinterpretation of official National Institute for Health and Care Excellence (NICE) guidance.

Dr Alasdair Rankin, Director of Research at the blood cancer research charity Bloodwise, said: “This decision means that people with CLL will no longer need to live with the fear and uncertainty of not knowing whether the most effective – and gentler – treatment will be available to them if they relapse.

“Ibrutinib was approved by NICE for use in the NHS for people with CLL who had relapsed after previous treatment. We were extremely concerned about how the decision to restrict access was made and the precedent it could set in relation to NHS England reinterpreting NICE guidance.

“It’s positive that NHS England are looking again at the way they implement NICE guidance, to ensure that the process of deciding what treatments will be provided by the NHS remains open and transparent and to ensure blood cancer patients maintain access to potentially lifesaving treatments in the future. We look forward to seeing further details of these proposals in due course.”

Ibrutinib was approved by NICE in January 2017 for use on the NHS for people with CLL who had relapsed or not responded to chemotherapy. It works by targeting and switching off a protein linked to cell growth in cancer cells and offers effective treatment without the side effects associated with chemotherapy.

Source: Bloodwise


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