Chemotherapy-free approach looks optimistic for older Chronic Lymphocytic Leukaemia patients

Professor Stephen Opat

An international clinical trial for Chronic Lymphocytic Leukaemia (CLL), including collaborators at Monash University, has examined a ‘chemotherapy-free’ drug combination in older patients for the first time.

Monash Health and Monash University researchers were the major Australian contributors to the international study, the results of which were published last week in Blood.

Director of Monash Haematology Professor Stephen Opat said it was the first time that a combination of two highly effective alternatives to chemotherapy were analysed in typical older patients with CLL who have other health concerns.

“Patients were given an antibody (obinutuzumab) directed against lymphoma cells and a drug (Venetoclax) that was developed here in Melbourne at the Walter and Eliza Hall Institute of Medical Research,” said study co-author Professor Opat.

 “The study showed the two therapies could be combined fairly safely and that at the end of the treatment (using a very sensitive molecular test), 11 out of 12 assessable patients had no evidence of disease in the bloodstream.”

The paper is a first look at the combination therapy, although the full study results won’t be available for many months.

“This study is very important because while CLL is very treatable, only a minority of patients would achieve this level or disease eradication—and they are usually younger patients receiving more aggressive chemotherapy,” said Professor Opat.

“Elimination of low levels of CLL has been associated with longer periods of disease control with some patients never needing to be retreated.”

CLL is the most common leukaemia adults, with a lifetime risk of 0.5-1%.