They live longer and better, with fewer side effects and without having to continually undergo therapy. It is an important milestone for chronic lymphatic leukemia patients that reached with a new treatment: a combination of drugs, without chemotherapy, can in fact be administered for the first time “with a fixed duration” of two years and then be suspended without the tumor returning or delaying any recovery of the disease for years. An even more relevant success if we consider that the patients enrolled in the trial had a relapsed or refractory leukemia, that is, they had already had a relapse or did not respond to previous therapies. Confirmation of the efficacy of the combination of venetoclax and rituximab, administered for 24 months, comes from the final analysis of the “Murano” study, which followed the patients for over five years.
About 3 thousand new cases a year in Italy
“Chronic lymphocytic leukemia diagnosis represents one of those life-changing encounters,” he says Sabrina Nardi, head of Ail (Italian Association of Leukemia, Lymphoma and Myeloma) -. The psychological impact for the recipient, for their family and social context, is very important: it is a treatable but currently not curable disease, which requires a daily coexistence with the disease, facing doubts about the future, expectations, and managing the impacts from a relational, work, economic and leisure time management point of view. Regaining possession of a good quality of life, cultivating one’s dreams and passions is essential. The positive data on treatments that last two years and then allow the interruption are an additional weapon available to patients for a new normal – continues Nardi -. It is therefore important for patients to continue to monitor sickness-free time data after discontinuation of therapy. ‘ In Italy there are about 3 thousand new cases a year of this blood cancer, which not infrequently can only be kept “under control” because it does not give symptoms and does not progress. Chronic lymphocytic leukemia predominantly occurs after the age of 60 and, depending on the characteristics, it can have a more or less aggressive trend: on average, about two thirds of patients are alive five years after diagnosis.
Benefits for patients, doctors and the health service
However, when the disease progresses, treatments are needed which are generally effective, but in a small percentage of patients, things get complicated. It is in this scenario that the binding of venetoclax (a new drug that acts as a “smart bullet” by blocking the mechanism by which the neoplastic cell reproduces) andrituximab monoclonal antibody proved to be particularly effective. “Today it is possible to live for a long time without progression of the disease and without chemotherapy with obvious advantages for the patient, for doctors and for the National Health Service – he comments. Antonio Cuneo, director of the Hematology Section of the Sant’Anna University Hospital of Ferrara -. The possibility of using a therapeutic regimen for a limited period of time, as in the case of venetoclax, represents a unique opportunity for the clinical management of chronic lymphatic leukemia, allowing the patient to resume their own life and to optimize resources for the health service “. The data from the final analysis of the «Murano» study confirm the benefit of the combination venetoclax plus rituximab over chemo-immunotherapy in terms of efficacy, understood as progression-free survival and overall survival. About half of the patients evaluated are still free from disease progression 3 years after the end of treatment. Venetoclax also makes it possible to obtain “profound answers” (which suggest a possible cure) and in an important percentage of patients the disease is no longer detectable with the diagnostic tools available today.
An effectiveness that lasts over time
“For blood cancers, treatments are increasingly effective and produce better and longer lasting responses – he underlines Francesca Romana Mauro, associate professor and medical director at the Institute of Hematology of the Sapienza University of Rome -. The long-term results of the “Murano” study confirm, in patients with relapsed or refractory chronic lymphocytic leukemia, the superiority of venetoclax and rituximab over the conventional therapeutic approach. The fixed duration treatment of two years with venetoclax and rituximab allows to reach very deep and prolonged responses over time: this treatment has in fact proved capable of delay the eventual recurrence of the disease even after more than 3 years from the suspension of therapy, with an improvement in the quality of life of the patients ». For decades, chemotherapy has been the only weapon available to cure this disease, but over the past 15 years, several new targeted drugs have arrived which have brought significant improvements and today the average survival for those suffering from chronic lymphatic leukemia exceeds 10 years from diagnosis. “The results of the” Murano “study confirm that patients with relapsed or refractory chronic lymphocytic leukemia can live longer without a subsequent relapse and we can thus delay any new treatments – he concludes Stefano Molica, director of the Onco-Hematological Department of the Pugliese-Ciaccio Hospital of Catanzaro -. Furthermore, time-limited therapy reduces the prevalence of treatment-related adverse events and offers a better quality of life for the patient, unlike continuous treatment ».
May 10, 2021 (change May 11, 2021 | 18:51)
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