A major UK clinical trial has found that combining two targeted drugs leads to better survival and fewer side effects than chemotherapy for people with chronic lymphocytic leukaemia (CLL), the most common form of leukaemia in adults.
The Flair trial involved 786 people with previously untreated CLL, treated across 96 cancer centres in the UK.
Participants were randomly assigned to receive standard chemotherapy, a single targeted drug (ibrutinib), or a combination of two targeted therapies – ibrutinib and venetoclax.
Treatment was guided by personalised blood tests.
After five years, the dual-drug group had a 94 per cent rate of survival without disease progression.
This compared with 79 per cent for those on ibrutinib alone and 58 per cent for those who received chemotherapy.
The trial also found that two years into treatment, 66 per cent of patients taking the drug combination had no detectable cancer in their bone marrow.
This compared with 48 per cent of those who received chemotherapy and none of those on ibrutinib alone.
Ibrutinib is a type of cancer growth blocker that works by stopping signals that cancer cells use to divide and grow. Venetoclax blocks the function of a protein found in CLL cells – a type of white blood cell – that helps them survive.
Dr Talha Munir, consultant haematologist at Leeds teaching hospitals NHS trust and lead investigator, said: “Flair trial is a milestone.
“We have shown that a chemotherapy-free approach can be not only more effective but also more tolerable for patients.
“By tailoring individualised treatment based on how well the cancer responds, we’re moving into an era of truly personalised medicine.”
The combined-drug treatment was also better tolerated than traditional therapies, with patients reporting fewer of the typical side effects linked to chemotherapy.
CLL affects white blood cells and weakens the immune system by breaking down the body’s ability to fight infection.
Around 4,000 people are diagnosed with the disease each year in the UK.
The study was funded by Cancer Research UK, alongside drug companies AbbVie and Johnson & Johnson.
Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, said: “The results show we can provide kinder, more targeted treatment for chronic lymphocytic leukaemia, which gives people with CLL more precious time with their loved ones.
“We’re hopeful that the results of the Flair trial will power new treatment options for leukaemia and other blood cancers, thanks to the efforts of researchers in Leeds and across the UK working together on this trial.”
