A groundbreaking UK-wide trial has found a chemotherapy-free approach to treating leukaemia that may lead to better outcomes for some patients, with the results being hailed as a “milestone”.
Led by researchers fromLeeds, results from the Flair trial, which took place at 96 cancer centres across the UK, could reshape the way the most common form of leukaemia in adults is treated, scientists said.
The trial set out to assess whether two targeted cancer drugs could perform better than standard chemotherapy among patients with chronic lymphocytic leukaemia (CLL).
It involved 786 people with previously untreated CLL who were randomly assigned to receive standard chemotherapy, a single targeted drug, ibrutinib, or two targeted drugs taken together, ibrutinib and venetoclax. Treatment was guided by personalised blood tests.
The trial found that after five years 94% of patients who received ibrutinib plus venetoclax were alive with no disease progression.
This compares with 79% for those on ibrutinib alone and 58% for those on standard chemotherapy, according to the study, which was published in the New England Journal of Medicine and presented to the European Haematology Association congress in Milan, Italy.
Meanwhile, 66% of patients on the combined drugs had no detectable cancer in their bone marrow after two years, compared with none of the people who received ibrutinib alone and 48% on chemotherapy.
Ibrutinib is a type of drug known as a cancer growth blocker. It works by stopping signals that cancer cells use to divide and grow. Venetoclax blocks the functions of a protein found in CLL cells.
The combined-drug regime was also tolerated better than traditional treatments, according to experts.
Dr Talha Munir, a consultant haematologist at Leeds teaching hospitalsNHStrust who led the study said: “Flair trial is a milestone. We have shown that a chemotherapy-free approach can be not only more effective but also more tolerable for patients.
“By tailoring individualised treatment based on how well the cancer responds, we’re moving into an era of truly personalised medicine.”
Dr Iain Foulkes, the executive director of research and innovation atCancerResearch UK, which funded the trial along with the drug companies AbbVie, and Johnson & Johnson, said: “The results show we can provide kinder, more targeted treatment for chronic lymphocytic leukaemia, which gives people with CLL more precious time with their loved ones.
“We’re hopeful that the results of the Flair trial will power new treatment options for leukaemia and other blood cancers, thanks to the efforts of researchers at in Leeds and across the UK working together on this trial.”
CLL is the most common form of leukaemia in adults. It affects white blood cells, breaking down the body’s ability to fight infection. About 4,000 people are diagnosed with CLL in the UK every year.
Catherine Whitfield, 63, from Farnley, West Yorkshire, was diagnosed with CLL in 2018 signed up to the trial, which was coordinated by the Leeds Cancer Research UK clinical trials unit at the University of Leeds and sponsored by the university.
She said: “After three years of treatment, I am still MRD [minimal residual disease]negative – that means no cancer cells.”