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Chemotherapy-free treatment option to be offered to patients with England’s most common leukaemia

April 21, 2021: A brand new oral treatment for an incurable blood cancer has been recommended for NHS use by NICE.

Acalabrutinib, taken as a twice daily tablet, is recommended as an option for adults with untreated chronic lymphocytic leukaemia (CLL).

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CLL is a malignant disorder of white blood cells and is the most common type of leukaemia in England. An estimated 2,395 patients will be eligible for treatment with acalabrutinib every year.

NICE has recommended the use of acalabrutinib, as a monotherapy option for adults with:

  • a 17p deletion or TP53 mutation, or
  • no 17p deletion or TP53 mutation, and fludarabine plus cyclophosphamide and rituximab (FCR), or bendamustine plus rituximab (BR) is unsuitable.

It can also be considered as an option for adults who have previously been treated for CLL.

Today’s decision means that people with CLL who have high-risk disease or cannot have standard chemotherapy can be offered the monotherapy treatment acalabrutinib which can be taken at home.

This is particularly beneficial during the current COVID-19 pandemic because it means that untreated CLL patients who would previously need to visit a hospital to have a combination therapy involving an intravenous administration no longer need to do so.

Meindert Boysen, deputy chief executive and director of the Centre for Health Technology Evaluation at NICE, said: “Chronic lymphocytic leukaemia has a debilitating effect on the daily lives of those living with it.

As the most common type of leukaemia in England, more targeted treatment options are very much needed and welcomed.

“Acalabrutinib is considered by patient experts who submitted evidence to NICE’s independent appraisal committee to be generally well tolerated and could cause fewer side effects than existing NHS treatments.

“Evidence submitted to our independent appraisal committee showed that acalabrutinib is clinically effective in chronic lymphocytic leukaemia and that it will improve the quality of life for those living with this condition. We are therefore very pleased to make this positive recommendation.”

A 30-day pack of acalabrutinib capsules, also known as Calquence and developed by AstraZeneca, costs £5,059. The company has a confidential commercial arrangement which allows NHS organisations to access the drug at a discount.

Each year it is estimated there are around 3,800-4,500 new cases of CLL. Men are nearly twice as likely to have CLL as women, with more than a third of cases occurring in people aged 75 and over.”



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