Patients in England and Wales will gain access to new first-line treatment options for chronic lymphocytic leukaemia and mantle cell lymphoma after NICE recommended two acalabrutinib-based combinations. AstraZeneca said the decision expands treatment choice across both blood cancers.
For CLL, NICE has endorsed the first all-oral, fixed-duration regimen incorporating a second-generation BTK inhibitor. For MCL, the recommendation introduces a targeted BTK inhibitor into the first-line pathway for eligible patients.
Dr Toby Eyre, Oxford University Hospitals NHS Foundation Trust, said: “We welcome NICE’s recommendation of acalabrutinib plus venetoclax for people living with chronic lymphocytic leukaemia in England.
He added: “This fixed-duration treatment option provides eligible patients with access to an innovative regimen that offers the flexibility of planned time off treatment. Expanding treatment choice through the NHS is an important step forward and may help reduce the burden of therapy while supporting patients to live well with their disease.”
The CLL decision is supported by the phase 3 AMPLIFY trial, where acalabrutinib plus venetoclax reduced the risk of disease progression or death by 35% versus chemoimmunotherapy. At three years, 77% of patients on the combination were progression-free.
Dr David Lewis, Plymouth Hospitals NHS Trust, explained: “NICE’s recommendation of acalabrutinib in combination with bendamustine and rituximab as a first-line treatment for mantle cell lymphoma is an important step for patients in England.
“As an incurable disease that mainly affects older people, optimising treatment from the outset is critical. This NHS access decision gives eligible patients the opportunity to benefit from the only targeted treatment currently available in the first-line setting and could help establish a new standard of care for transplant-ineligible patients.”
Dallas Pounds, Lymphoma Action, added: “A blood cancer diagnosis can have a significant impact on every aspect of a person’s life, so having access to a range of effective treatment options is incredibly important.
He concluded: “These recommendations give eligible people with MCL greater choice, allowing treatment decisions to better reflect each person’s clinical needs, lifestyle and preferences.”
The MCL recommendation is supported by the phase 3 ECHO trial, where acalabrutinib plus bendamustine and rituximab improved progression-free survival to 66.4 months versus 49.6 months.
