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ASH 2024 | Practice-changing updates in CLL from ASH 2024: findings from the AMPLIFY trial
Piers Patten, MB ChB, MRCP, FRCPath, PhD, King’s College London, London, UK, discusses the potentially practice-changing updates in chronic lymphocytic leukemia (CLL) from ASH 2024. He highlights the AMPLIFY trial (NCT03836261), which showed promising outcomes for the combination of acalabrutinib and venetoclax in the front line. Dr Patten notes that discussions on licensing and reimbursement will take place over the next few months, but he is optimistic about the potential for this regimen to become available in the NHS. This interview took place at the 66th ASH Annual Meeting and Exposition, held in San Diego, CA.
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Transcript
I don’t think there are going to be any immediate changes in practice tomorrow, but I think the big change will be the presentation of the AMPLIFY data. AMPLIFY is a study looking at three regimens. The standard care arm was either FCR or BR chemoimmunotherapy, something we no longer use in the UK, but it is a typical comparator for any studies really in frontline CLL. And two experimental arms, one was a fixed duration 14-month acalabrutinib and venetoclax regimen, and the other was a similar regimen with the addition of obinutuzumab...
I don’t think there are going to be any immediate changes in practice tomorrow, but I think the big change will be the presentation of the AMPLIFY data. AMPLIFY is a study looking at three regimens. The standard care arm was either FCR or BR chemoimmunotherapy, something we no longer use in the UK, but it is a typical comparator for any studies really in frontline CLL. And two experimental arms, one was a fixed duration 14-month acalabrutinib and venetoclax regimen, and the other was a similar regimen with the addition of obinutuzumab. Now, I don’t know what will happen in terms of licensing for UK practice or then reimbursement, but I’m fairly sure that those discussions will be happening over the next few months. And I have a feeling that we may well have at least one of the experimental regimens available for us in the NHS. The data presented at ASH definitely showed a good progression-free survival rate for the acalabrutinib and venetoclax arm. But it’s still very early days. I think the study was affected by being performed during the pandemic. So there was unfortunately quite a few deaths due to COVID. And I think probably we’re going to need to see over time how this data compares to the other regimens we have out there. But from a toxicity point of view, I think the data was impressive. There were very low rates of atrial fibrillation, for example, which is always a concern we’ve had with a combination of the first-generation agents, such as ibrutinib along with venetoclax. And so I think it could be an attractive fixed-duration regimen to go to, but it’s early days, and we really need to see where it is, as it reports out again and again. But I think that’s probably going to be the biggest practice change in 2025 that I can see that we’re going to have an additional frontline regimen, which, I mean, can only be good news.
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Disclosures
Novartis: Research Funding; Janssen: Honoraria, Other: Travel, accommodations, expenses, Research Funding; BeiGene: Honoraria, Other: Travel, accommodations, expenses, Research Funding; AbbVie: Honoraria, Other: Travel, accommodations, expenses, Research Funding; AstraZeneca: Honoraria, Research Funding.
