Current NICE/CDF drug approvals for CLL

NICE / CDF approvals for novel therapies in CLL as of October 2023

(England)

Front-line

Options

No TP53 mutation or deletion

FCR/BR unsuitable

  • Acalabrutinib
  • Ibrutinib + Venetoclax
  • Venetoclax + Obinutuzumab
  • Zanubrutinib

FCR/BR suitable

  • Ibrutinib + Venetoclax
  • Venetoclax + Obinutuzumab (CDF)

 

TP53 mutated/deleted
  • Acalabrutinib
  • Ibrutinib
  • Ibrutinib + Venetoclax
  • Idelalisib + Rituximab (only if other therapies not suitable)
  • Venetoclax + Obinutuzumab
  • Zanubrutinib

Lymphoid leukaemia NICE Pathways

NICE / CDF approvals for novel therapies in CLL as of October 2023

(England)

Relapse

Options

No TP53 mutation or deletion

Prior Venetoclax and/or chemoimmunotherapy

  • Acalabrutinib
  • Ibrutinib
  • Zanubrutinib

Prior BTKi and/or chemoimmunotherapy

  • Venetoclax + Rituximab

Prior BTKi and chemoimmunotherapy

  • Venetoclax monotherapy (CDF)

 

TP53 mutated/deleted

Prior BTKi therapy or if BTKi unsuitable

  • Venetoclax monotherapy (CDF)

 

All patients for relapse < 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)