NICE to recommend venetoclax with rituximab for CLL

This week, the National Institute for Health and Care Excellence (NICE) has recommended the use of venetoclax with rituximab for people with chronic lymphocytic leukaemia (CLL) that has not responded to treatment (refractory) or has come back after treatment (relapsed).

Ritixumab is an antibody therapy that binds to a protein called CD20 on the surface of B cells. This causes your own immune system to destroy the B cells.

Venetoclax is a targeted drug that block proteins that stop lymphoma cells dying. When these proteins are blocked, the lymphoma cells go through a process called ‘programmed cell death’.

Venetoclax is already available through the Cancer Drugs Fund for people with CLL:

• with certain genetic changes (17p deletion or TP53 mutation) and when a B-cell receptor pathway inhibitor (for example, idelalisib or ibrutinib) is unsuitable, or whose disease has progressed (got worse) after a B-cell receptor pathway inhibitor
• without a 17p deletion or TP53 mutation, and whose CLL has progressed after both chemo-immunotherapy (chemotherapy with antibody therapy) and a B-cell receptor pathway inhibitor.

The new NICE guidance means that in combination with rituximab, venetoclax will now be routinely available on the NHS for adults with CLL who have had at least one previous course of treatment. This chemotherapy-free combination has been shown to be more effective than current treatment options and its availability on the NHS is positive news for people with relapsed or refractory CLL in England.