In 2023, the chronic lymphocytic leukemia (CLL) space was full of advancements, including a focus on BTK inhibitors, the benefit of determining a patient’s minimal residual disease status and strategies to manage different stages of the disease.
CURE looked back at the most read and influential stories on CLL throughout 2023.
BTK Inhibitors Offer a Revolutionary Treatment of Relapsed CLL/SLL
Penny Isop’s journey with CLL began in 2012. Despite the initial diagnosis, her condition rapidly worsened, and traditional treatments proved ineffective due to aggressive cancer characteristics. Participating in a clinical trial, she received an innovative combination of immunotherapy drugs, leading to a remarkable response and temporary remission.
However, a subsequent resurgence of CLL prompted a shift to Bruton tyrosine kinase (BTK) inhibitors, with Isop experiencing the side effect of atrial fibrillation (AFib) linked to the drug Imbruvica (ibrutinib). This revelation underscored a previously unnoticed risk associated with the groundbreaking treatment. Isop eventually transitioned to the newer BTK inhibitor, Brukinsa (zanubrutinib), which demonstrated superior efficacy in clinical trials and a reduced risk of AFib.
Brukinsa’s recent approval for CLL marked a significant milestone, with studies showing its effectiveness and safety in comparison to Imbruvica. Notably, the SEQUOIA trial highlighted Brukinsa’s efficacy in challenging CLL cases, presenting a promising alternative to conventional chemoimmunotherapy.
After More Than a Decade with CLL, MRD Results Left Patient ‘Over the Moon’
Geoff Grubbs has been navigating the challenges of CLL for nearly 15 years. Despite undergoing five lines of treatment and participating in two clinical trials, Grubbs recently received a beacon of hope.
In an interview with CURE, Grubbs shared the exhilarating news that, for the first time since his initial diagnosis, he has achieved complete remission. The 72-year-old expressed his jubilation, stating, “I am so excited. This has never happened to me before, nothing like it.”
Breyzani Benefits Previously Treated SLL, CLL
Breyanzi (lisocabtagene maraleucel), a cutting-edge CAR-T cell therapy, has demonstrated significant benefits for individuals grappling with relapsed or refractory CLL or small lymphocytic leukemia (SLL), as revealed by recent research published in The Lancet.
The comprehensive findings underscore that patients facing relapsed or refractory CLL or SLL, having exhausted conventional treatment options, can experience noteworthy improvements through T-cell therapy. This innovative form of immunotherapy harnesses the power of a patient’s own immune cells. By modifying T cells and reintroducing them into the body, the therapy empowers the immune system to combat and eradicate cancer.
FDA Accepts Priority Review for Breyanzi in CLL
The recent acceptance by the Food and Drug Administration (FDA) of the supplemental Biologics License Application (sBLA) for Breyanzi (lisocabtagene mareleucel) marks a significant step forward in its potential application. This acceptance pertains to the treatment of patients contending with relapsed or refractory CLL or small lymphocytic lymphoma (SLL) who have previously undergone treatment with a BTK inhibitor and a B-cell lymphoma 2 inhibitor (BCL2i). Bristol Myers Squibb conveyed this pivotal development in a recent press release, underscoring the FDA’s recognition of the therapy’s potential in addressing specific patient populations.
Standard Approach for Inactive, Early CLL Remains a Wait-and-Watch Strategy
The prevailing standard of care for patients with early-stage CLL characterized by inactive disease continues to be a watch-and-wait approach, as indicated by the conclusions drawn from a recent phase 3 trial. Dr. Petra Langerbeins presented the conclusive results of the phase 3 CLL12 trial at the 2023 EHA Congress, reinforcing the established protocol for managing this particular subset of CLL patients.
An earlier analysis had previously revealed that Imbruvica showcased a notable enhancement in event-free survival among individuals grappling with early-stage disease, offering promising insights into potential advancements in CLL treatment strategies.
Venclexta Plus Gazyva Induces Minimal Residual Disease, Improves Survival in CLL
In a recent phase 3 trial, it was revealed that the first-line approach utilizing Venclexta (venetoclax) and Gazyva (obinutuzumab), with or without the addition of Imbruvica, outperformed chemoimmunotherapy for patients grappling with CLL. Published in The New England Journal of Medicine, the trial results underscore the superior efficacy of the Venclexta and Gazyva combination, irrespective of the inclusion of Imbruvica, in achieving undetectable minimal residual disease and extending progression-free survival for individuals diagnosed with CLL.
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