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Leukaemia patients to be offered at-home non-chemotherapy drug

Opioid epidemic, drug abuse and overdose concept with scattered prescription opioids spilling from orange bottle with copy space. Hydrocodone is the generic name for a range of opiate painkillers
An at-home treatment may be particularly useful amid the pandemic. (Stock, Getty Images) (Moussa81 via Getty Images)

Patients with a common form of leukaemia now have a chemotherapy-free treatment option.

The National Institute for Health and Care Excellence (Nice), the UK's health watchdog, has recommended the twice-a-day drug acalabrutinib for adults with chronic lymphocytic leukaemia (CLL).

CLL, the most common form of leukaemia in England, affects immune cells called lymphocytes.

Treatment decisions previously focused on chemotherapy or a "targeted cancer drug".

Nice now advises acalabrutinib be offered to patients with specific genetic mutations, as well as when other medications are unsuitable or unsuccessful.

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Studies suggest the drug is a cost-effective way of improving "progression-free survival".

The at-home therapy may be particularly beneficial amid the coronavirus pandemic, avoiding the need for patients to have intravenous administrations in hospital.

Destruction of leukaemia blood cell, computer illustration. Conceptual image for leukaemia treatment.
Chronic lymphocytic leukaemia affects specific immune cells. (Stock, Getty Images) (KATERYNA KON/SCIENCE PHOTO LIBRARY via Getty Images)

Around 3,800 people are diagnosed with CLL in the UK every year.

The slow-developing disease is more common among the elderly and "very rare" in people under 40.

Men are more likely to develop CLL than women, for unclear reasons.

"Chronic lymphocytic leukaemia has a debilitating effect on the daily lives of those living with it," said Meindert Boysen, deputy chief executive of Nice.

"As the most common type of leukaemia in England, more targeted treatment options are very much needed and welcomed.

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"Acalabrutinib is considered by patient experts who submitted evidence to Nice's independent appraisal committee to be generally well tolerated and could cause fewer side effects than existing NHS treatments.

"Evidence submitted to our independent appraisal committee showed acalabrutinib is clinically effective in chronic lymphocytic leukaemia and it will improve the quality of life for those living with this condition.

"We are therefore very pleased to make this positive recommendation."

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Nice is recommending acalabrutinib, brand name Calquence, as a standalone treatment in patients with specific genetic mutations.

Those without these DNA changes may be offered the drug alongside other therapies.

Acalabrutinib could also be considered for adults who have previously been treated for CLL, according to Nice.

Patients with "high-risk disease" or who "cannot have standard chemotherapy" may also be offered the drug as a standalone therapy.

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Overall, 2,395 patients are thought to be eligible for acalabrutinib every year.

Nice recommends drugs based on a cost-benefit analysis. A 30-day pack of acalabrutinib capsules, developed by AstraZeneca, is priced at £5,059 ($7,033).

The pharmaceutical giant has a confidential commercial arrangement that allows the NHS to access the drug at a discount.

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