Current NICE/CDF drug approvals for CLL

NICE / CDF approvals for novel therapies in CLL as of October 2021

(England)

Front-line

Options

No TP53 mutation or deletion FCR/BR unsuitable

•      Acalabrutinib

•      Venetoclax + Obinutuzumab

FCR/BR suitable

•      Venetoclax + Obinutuzumab (CDF)

TP53 mutated/deleted •      Acalabrutinib

•      Ibrutinib

•      Idelalisib + Rituximab (only if other therapies not suitable)

•      Venetoclax + Obinutuzumab

Lymphoid leukaemia NICE Pathways

NICE / CDF approvals for novel therapies in CLL as of October 2021

(England)

Relapse

Options

No TP53 mutation or deletion Prior Venetoclax and/or chemoimmunotherapy

•      Acalabrutinib

•      Ibrutinib

Prior BTKi and/or chemoimmunotherapy

•      Venetoclax + Rituximab

Prior BTKi and chemoimmunotherapy

•      Venetoclax monotherapy (CDF)

TP53 mutated/deleted Prior BTKi therapy

• Venetoclax monotherapy (CDF)

All patients for relapse within 24 months Idelalisib + Rituximab

Lymphoid leukaemia NICE Pathways

  • NICE: National Institute of Clinical Excellence
  • CDF: Cancer Drugs Fund
  • FCR: Fludarabine, Cyclophosphamide, Rituximab
  • BR: Bendamustine, Rituximab
  • BTKi: Bruton’s Tyrosine Kinase inhibitor (Acalabrutinib, Ibrutinib)