Cancer Advance of the Year: Transformation of CLL Treatment

January 20, 2015
Amber Bauer, ASCO staff

Clinical research has brought about tremendous progress in cancer care, resulting in longer survival and better quality of life for the more than half a million Americans diagnosed with cancer each year. During the last decade, more than 60 new cancer drugs have been approved by the U.S. Food and Drug Administration (FDA). Entire new classes of drugs have been developed, each targeting a specific molecule, gene, or protein required for tumor survival, growth, or spread.

In the last year alone, four new therapies were approved for patients with chronic lymphocytic leukemia (CLL). These treatments are more effective and cause far fewer side effects than the treatment options that were previously available. For this reason, ASCO has named the transformation of CLL treatment the cancer Advance of the Year in its Clinical Cancer Advances 2015 report.

“This has truly been a banner year for CLL and for clinical cancer research as a whole,” said ASCO President Peter P. Yu, MD, FASCO. “Advances in cancer prevention and care, especially those in precision medicine, are offering stunning new possibilities for patients.”  

2014—the year that transformed CLL treatment

CLL is the most common adult leukemia, and approximately 90% of people who are diagnosed are over the age of 55. However, until last year, many older patients had few treatment options. For years, the standard treatment for CLL has been a combination of chemotherapy (fludarabine [Fludara]/cyclophosphamide [Neosar]) and targeted therapy (rituximab [Rituxan]). Most older adults, though, are unable to tolerate standard treatment because of severe, even life-threatening, side effects.

In 2014, people who had just been diagnosed with CLL gained two new treatment options that are far more effective than existing drugs. When combined with chemotherapy, obinutuzumab (Gazyva) and ofatumumab (Arzerra) extend the amount of time until CLL gets worse by roughly a year. These drugs are known as immunotherapies, which is a type of cancer treatment designed to boost the body's natural defenses to fight the cancer.

For patients with CLL that has come back after treatment or become resistant to standard treatment, two new targeted drugs, ibrutinib (Imbruvica) and idelalisib (Zydelig), are so effective they are poised to transform CLL care, potentially eliminating the need for chemotherapy.

4 New Options for CLL Treatment

“These new therapies fill an enormous need for thousands of patients living with CLL,” said Gregory Masters, MD, FACP, FASCO, ASCO expert and co-executive editor of the Clinical Cancer Advances report. “For many older patients, especially, these drugs essentially offer the first chance at effective treatment, since the side effects of earlier options were simply too toxic for many to handle.” 

Cancer advances—past, present, and future

In addition to announcing the Advance of the Year, the special 10th anniversary issue of the Clinical Cancer Advances report includes two special sections. “A Decade in Review” describes the biggest changes in cancer care during the last 10 years, and “The 10 Year Horizon” previews the research that is likely to shape the next decade of cancer care, including genomic technology, nanomedicine, and information technology.


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