Current NICE/CDF drug approvals for CLL

NICE / CDF approvals for novel therapies in CLL as of February 2025 (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

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