Hopes grow for oral drug alternative to chemotherapy to treat leukaemia

Oral treatments for some leukaemias are showing promise as a first line of defence and now advocates want them to be the first choice instead of chemotherapy.

Increasing evidence shows oral therapies can be more effective than chemotherapy for many CLL and SLL patients.

Hopes are rising that chemotherapy-free treatments can become a first-line defence against leukaemias to cut the side effects on patients and speed up their chances of recovery.

Cancer advocates are using an Australian medical conference this week to push for newly developed oral therapies to be classified a first choice treatment for Chronic Lymphocytic Leukaemia (CLL) and Small Lymphocytic Lymphoma (SLL).

The move comes as the federal government’s consultation continues into whether groundbreaking but expensive drugs ibrutinib, combined with venetoclax, should be funded as a frontline treatment through the PBS.

Currently the once-daily pills are only made available to recently diagnosed leukaemia patients after they have already undergone unsuccessful chemotherapy, at a cost of about $210,000 for a typical 15-month round of treatment.

Increasing evidence shows oral therapies can be more effective than chemotherapy for many CLL and SLL patients.

But with increasing evidence showing the oral therapies can be more effective than chemotherapy for many CLL and SLL patients, Lymphoma Australia chief executive officer Sharon Winton said it was time to stop putting people through ineffective and distressing chemo as the only frontline option.

“There is an urgent need for better treatments than chemotherapy which we know can be

brutal and is ineffective for many people with specific genetic mutations,” Ms Winton said from the Blood 2022 medical conference in Sydney.

“We support these new oral treatments being available for Australians, rather than withheld on cost grounds.

“It is wrong to force people to endure therapies that may be less effective before they qualify for these new treatment regimens.”

Haematologist Dr Mary Ann Anderson says patients are having great outcomes and they’re living much higher-quality lives. Picture: David Caird

About 1300 Australians are diagnosed with CLL or SLL each year. The diseases form in the tissue inside bones where blood cells are made, leaving the body vulnerable to life-threatening infections.

Haematologist Dr Mary Ann Anderson — who has been involved in the development of venetoclax through her work at the Peter Mac and Royal Melbourne hospitals as well as the Walter and Eliza Hall Institute — said the new therapies were making a huge change to the treatment of those who could access them, typically through a clinical trial.

“Patients are not developing all those traditional chemotherapy side effects, they’re having great outcomes and they’re living lives that have a much higher quality compared to what we saw during chemotherapy. So it’s just really a wonderful advance for our patients,” Dr Anderson said.

Pete Stockton, pictured with his family, says he hasn’t had any side effects of medication.

“Where we would like to see the field heading is where we can actually offer patients a completely chemo free journey so that we can control their CLL from the beginning to the end of their journey without having to resort to him therapy with all its traditional side effects. “And I think that we are very close as a community to achieving that.”

Diagnosed with CLL in 2017, Pete Stockton said he was “staring down the barrel” of chemotherapy until referred to the Peter Mac and offered a place on a clinical trial of imbruvica in combination with venetoclax.

“I just didn’t hesitate,” Mr Stockton, 60, said.

“The medication basically returns my white blood cell count back to normal and I just live a normal life.

“I’m very lucky, I haven’t had any side effects of medication whatsoever.”

Of the 168 people involved in the international trial, 80 per cent went into full remission and are cancer free.

While Mr Stockton still has some barely-detectable levels of residual cancer, he is able to live a normal life and is keen for others to benefit in the same way.

“For your average person … I’m not even sure how they would manage the cost.

“But if you’re offered the medication first then it’s going to be less invasive for you, you don’t have to take time off work you can continue your career and people can continue contributing positively to society rather than suffering at home through chemotherapy.”