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New treatment method for chronic lymphocytic leukemia

Combination therapy works better and has fewer side effects
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(Vienna, 17-05-2023) A recent study involving MedUni Vienna and University Hospital Vienna has identified a significant advance in the treatment of chronic lymphocytic leukaemia (CLL). The results of the randomised Phase III CLL13 (GAIA) study show that a time-limited and targeted therapy with venetoclax and obinutuzumab is more effective than chemoimmunotherapy in patients without comorbidities. The findings have the potential to revolutionize the standard of care for CLL patients and offer them a better quality of life. The study was published in the prestigious journal The New England Journal of Medicine.

In the independent study, many of the 926 CLL patients in Austria were able to participate and benefit from the results under the coordination of Philipp Staber from the Division of Hematology and Hemostaseology at the Department of Medicine I at MedUni Vienna and University Hospital Vienna. In Austria, patients were included at Hanusch Hospital Vienna in addition to the University Hospital Vienna. Philipp Staber, a member of the Comprehensive Cancer Center Vienna of MedUni Vienna and University Hospital Vienna, emphasizes the clear advantage of the combination therapy consisting of the BCL-2 inhibitor venetoclax and the anti-CD20 antibody obinutuzumab. "In 86.5% of patients, the therapy leads to such a strong reduction of CLL cells that they can no longer be detected in the patient's blood (MRD negativity), and enables a long-lasting freedom from disease. In addition, fewer side effects occur compared to chemoimmunotherapy."

New standard for CLL patients
The study also investigated whether additional treatment with ibrutinib would provide further benefits. However, this more intensive treatment led to an increased number of side effects without additional benefit for the patients. Based on the results of the study, the study authors now recommend the combination therapy of obinutuzumab and venetoclax as the new standard of care for fit CLL patients, regardless of age.

"This is a major advance in the treatment of CLL and offers hope for affected patients. This targeted therapy has the potential to improve patients' quality of life and enable them to remain disease-free and therapy-free for longer", says Philipp Staber, who, as a member of the strategy committee, was also involved in the study design together with Ulrich Jäger from the Department of Medicine I at MedUni Vienna and University Hospital Vienna.

Publication: The New England Journal of Medicine
First-Line Venetoclax Combinations in Chronic Lymphocytic Leukemia
Barbara Eichhorst, Carsten U. Niemann, Arnon P. Kater, Moritz Fürstenau, Julia von Tresckow, Can Zhang, Sandra Robrecht, Michael Gregor, Gunnar Juliusson, Patrick Thornton, Philipp B. Staber, Tamar Tadmor, et.al., for the GCLLSG, the HOVON and Nordic CLL Study Groups, the SAKK, the Israeli CLL Association, and Cancer Trials Ireland
N Engl J Med 2023; 388:1739-1754
DOI: 10.1056/NEJMoa2213093