• Sun. Oct 17th, 2021

Hematologists: ‘For blood neoplasms increasingly effective and lasting treatments’

Byeditorial

May 6, 2021

“For blood cancers, treatments are increasingly effective and produce better and longer lasting responses. The long-term results of the ‘Murano’ study confirm, in patients with relapsed / refractory chronic lymphocytic leukemia (CLL), the superiority of the venetoclax combination. and rituximab compared to a conventional chemoimmunotherapy therapeutic approach. The fixed duration treatment of 2 years with venetoclax and rituximab allows to reach very deep and prolonged responses over time. This biological and chemo-free treatment has been shown to delay any possible recovery of the disease even after more than 3 years from the suspension of therapy. A more effective and time-limited therapeutic management of the disease favors the improvement of the patient’s quality of life “. This was stated by Francesca Romana Mauro, associate professor and medical director at the Institute of Hematology of the Sapienza University of Rome, on the occasion of the web conference “Chronic lymphatic leukemia: fixed-duration therapy transforms the standards of care for a better quality of patient’s life ”promoted by AbbVie, with the participation of Ail, the Italian association against leukemia-lymphomas and myeloma. “The study – explains Mauro – has demonstrated the superiority of this chemo-free and totally biological approach with the combination venetoclax and rituximab compared to conventional chemoimmunotherapy both in terms of response duration and in terms of survival. In almost 2/3 of the treated patients it was not possible to document, even with sophisticated laboratory techniques, the presence of residual leukemia cells in the peripheral blood. This is a very important and surprising result, because we hematologists – he underlines – know well that the deeper the response, the longer the period of remission, the patient’s well-being and the time in which the signs of the disease will no longer be present. , so there will be no need to resume a treatment. Biological therapy is also oral, venetoclax is a drug that can be administered orally, so the patient can take it comfortably at home without being forced to undergo infusions of chemotherapy drugs in the hospital “. Chronic lymphocytic leukemia is a slow-growing form of leukemia: in addition to being the most common form of leukemia in Western countries, it accounts for about one third of new leukemia diagnoses in Europe. In our country, around 1,200 people are diagnosed with LLC each year. A chemo-free and oral therapy has a significant impact on the quality of life of patients and their families, but also on clinicians and the NHS. “Today it is possible to live for a long time without disease progression – confirms Antonio Cuneo, director of the Hematology Section of the Aou Arcispedale Sant’Anna in Ferrara – and without chemotherapy with obvious advantages for the patient, for doctors and for the National Health Service . The possibility of using a therapeutic regimen for a limited period of time, as in the case of venetoclax, represents a unique opportunity for the clinical management of chronic lymphatic leukemia, allowing the patient to resume their life as well as to optimize resources for the Ssn “. For Cuneo, it is also essential to establish a doctor-nurse-patient alliance “because this allows the Hematology Center – says the hematologist – to manage the patient in an ideal manner during all phases of treatment: from the first 6 months that require attention more frequent in the following 18 months during which the patient takes only oral therapy and even more in the following years during which the patient has suspended therapy and has the disease in remission “. “The results of the ‘Murano’ study – says Stefano Molica, Onco-Hematological Department of the Pugliese-Ciaccio hospital in Catanzaro – confirm that patients with relapsed / refractory chronic lymphatic leukemia can live longer without a subsequent relapse of the disease and thus delaying any new treatments -. In addition, time-limited therapy reduces the prevalence of treatment-related adverse events and a better quality of life for the patient, unlike continuous treatment ”. Many patients with CLL are elderly with comorbidities. “These are people – continues Molica – who often have to undergo cataract surgery or a more complex surgical operation. For these reasons they need to stop the therapy. But when a therapy is stopped, there is usually a re-explosion of the disease. From the data we have we know that the interruption of treatment even up to 21 days with venetoclax does not result in any change in the patient’s disease status. This means that the profound response and the mechanism of action linked to venetoclax in fact also allow those interruptions that may exist in an elderly patient without all of this having a negative impact on the control of the disease. And it is something of no small importance in patient management ”, he concludes.