Royal College of Surgeons in Ireland Coláiste Ríoga na Máinleá in Éirinn

New leukaemia drug boosts survival rate to 90% and could eventually replace invasive chemical treatment

16 June 2014

Patients in Ireland have been involved in a breakthrough international trial of a new cancer drug which has given researchers renewed hope in the fight against leukaemia.  Research published in the New England Journal of Medicine has found Ibrutinib, an inhibitor of Bruton’s Kinase, to have better rates of survival for patients with the commonest form of leukaemia than conventional therapy and is a breakthrough for people with resistance to chemotherapy.

The results of a trial on 391 patients showed the drug Ibrutinib gave patients fighting a type of slow growing blood cancer called Chronic lymphocytic leukaemia (CLL) a 90 per cent chance of survival, compared to 81 per cent who survive on more conventional treatment.

Dr Patrick Thornton, Consultant Haematologist, Senior Lecturer RCSI and co-author of a New England Journal of Medicine report said “Ireland was per capita the highest recruiter globally to this trial. During the trial the patients responded quicker to the new drug than to monoclonal antibody therapy and showed fewer side effects. The trial also found that patients, who had not responded to, or have resistance to chemotherapy, now have an alternative treatment option. This drug represents a complete paradigm shift in the treatment of leukaemia which could replace the need for chemotherapy at all and changes completely how leukaemia can be treated.”

The research found the drug is better tolerated than traditional forms of treatment, and is an alternative for patients whose cancer cells have built up a resistance to chemotherapy. Results from the trial also showed that four out of every 10 patients entered remission within a year, compared to four in 100 on a traditional treatment

Ibrutinib works by disabling the enzyme, Bruton’s Kinase, crucial for Leukaemia's survival. Due to the success of the clinical trial Dr Thornton said “Ibrutinib is now available to patients with the aggressive and chemotherapy resistant forms of CLL in Ireland.”

Although one of the rarest forms of cancer, CLL is the most common type of leukaemia and the older you are the higher the chance you have of developing it. Almost 80 per cent of all new cases are diagnosed in people over the age of 60.  It occurs more frequently in men than women, and because it develops slowly, many people don't show symptoms in its early stages.  Many people can live for a long period of time with CLL, however there are aggressive variants, such as P53 deleted CLL which may be fatal in only a few years despite chemotherapy. This new treatment gives tremendous hope to these patients as it can overcome the usual resistant mechanisms seen in refractory chemotherapy resistant cases.

Leukaemia Facts: 
• Chronic Lymphocytic Leukaemia (CLL) is a slow growing leukaemia that affects specialised white blood cells known as Lymphocytes
• Its symptoms include swollen lymph nodes, pain or discomfort under the ribs, anaemia, excessive sweating and weight loss
• About 30 per cent of people diagnosed with CLL never require treatment, while for 70 per cent the disease can spread and multiply
• There are approximately 500 Leukaemia diagnoses each year in Ireland of which around 40% of these are CLL
• More than 200 people in Ireland die every year of Leukaemia