- Much has changed in the treatment of chronic lymphocytic leukemia in recent years. International recommendations clearly indicate a move away from immunochemotherapy toward new therapies. Currently, two groups of therapeutics are widely used. These are BTK inhibitors and BCL2 inhibitor drugs. What is important is that the availability of these therapies in Poland is firstly, and secondly: expanding," says Prof. Krzysztof Giannopoulos, head of the Department of Experimental Hematology at the Medical University of Lublin. The needs of hematologists now include better access to modern BTK inhibitor therapies. Therapies that combine two oral drugs are also not insignificant for patient comfort and systemic benefits.
Chronic lymphocytic leukemia is already being treated according to global standards. What is needed is better access to two-drug regimens based on the new BTK inhibitor
Published Sept. 27, 2023 14:06
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Hematologists agree that it can be said that currently in Poland, patients with chronic lymphocytic leukemia are treated according to world standards. However, new studies are emerging that confirm that the direction of change, associated with the move away from immunochemotherapy, is also correct in groups of patients with a favorable prognosis.
- One can basically identify two areas that could be improved in terms of reimbursement. This is first-line treatment, for patients who have a favorable genetic prognosis. Here we only have accessibility to immunochemotherapy, so there is no choice, and given the results of a study comparing it with venetoclax in combination with the anti-CD20 antibody, obinotuzumab, the toxicity of the newer regimen was shown to be much lower. The second area is the expansion of accessibility to BTK inhibitors. A new second-generation inhibitor is currently in the reimbursement process. It shows a better safety profile and greater efficacy compared to older therapies," Prof. Krzysztof Giannopoulos mentioned.
The needs of PBL treatment were much discussed at the recently held conference of the Polish Coalition of Oncology Patients "Start with Blood". Prof. Iwona Hus, head of the Department of Clinical Transplantation at the Medical University of Lublin, stressed that according to studies conducted in Germany, it appears that the aforementioned treatment, based on venetoclax and obinutuzumab, has shown great benefits for patients.
- We also have a second regimen - venetoclax and ibrutinib - which also has first-line registration. We are waiting for these two regimens, and I think this would result in us being able to treat patients with chronic lymphocytic leukemia according to international standards. If this is successful, we will be able to act in accordance with the guidelines," Prof. Iwona Hus pointed out.
- This is a combination of two new treatments: an oral BTK inhibitor and an oral BCL2 inhibitor. This treatment, compared to BTK inhibitor monotherapy, is a time-defined treatment. Here we take advantage of the efficacy of the drugs without exposing patients to prolonged exposure and side effects. This is where I would certainly see an advantage. The second thing is that both of these drugs are oral. In all hematology centers, patients struggle with queues, and if a patient can be treated fully on an outpatient basis, this is a huge systemic benefit. In turn, the benefit to the patient is that if the two drugs are oral, such a person is not excluded from social or even professional life. This is something we could not talk about with immunochemotherapy," adds Prof. Krzysztof Giannopoulos.
