UK CLL Study Group Strategy 2026–2030

The UK CLL Study Group provides the national forum for coordinating clinical and translational research in chronic lymphocytic leukaemia (CLL). Building on UK trials delivered over the last 4 decades, the group now aims to strengthen the UK’s position as a leader in innovative, patient centred CLL research. This strategy outlines the collective vision for 2026–2030, aligning clinical and translational priorities under a single framework. This document reflects discussions held at the October 2025 Study Group Meeting, and has been developed to sit within both the aims of the UK CLL Forum and the UK Blood Cancer Research Network.

Purpose

• To meet the UK CLL Forum Objects of
• Developing and promoting clinical trials of treatment of CLL and similar conditions and linked scientific studies.
• Encouraging collaborative research in CLL and similar conditions.
• To define a cohesive national strategy for CLL clinical trials, translational science, and patient engagement.
• To ensure that UK led CLL research remains globally competitive, inclusive, and sustainable.
• To support the development of the next generation of clinical leaders and research infrastructure.
• To work with and closely align to the Blood Cancer UK (BCUK) Haematology Research Network.

The strategy recognises the pivotal achievements of our recent trials, especially those utilising the combination of ibrutinib and venetoclax in a personalised (MRD-guided) approach. Outputs from studies such as FLAIR have redefined expectations for depth and duration of remission for CLL patients. The strategy focuses on consolidating those gains, extending innovation to all CLL patients, and integrating translational biology with pragmatic clinical design.

The Study Group proposes five guiding principles to underpin all UK CLL research and trial activity. These principles provide a unifying framework for concept development, funding applications, and collaboration across institutions.

2.1 Personalised, Risk Adapted Management

Individualising therapy according to disease biology, MRD status, and comorbidity profile. The goal is to move from a “one size fits all” model towards risk stratified treatment, optimising outcomes and minimising toxicity.

2.2 Patient Centred Orientation

Embedding patient experience, quality of life, and survivorship endpoints as core trial outcomes. Structured Patient and Public Involvement and Engagement (PPIE) will be incorporated at every stage of trial design and governance.

2.3 Precision and Translational Integration

Ensuring that every major UK CLL trial includes embedded correlative science and data linkage, utilising and improving existing resources such as the UK CLL Biobank in Liverpool. This integration will strengthen biological understanding, facilitate cross trial analyses, and attract international and industry collaboration.

2.4 Comprehensive Scope Across the CLL Pathway

While the principal strategic focus remains on front line and relapsed/refractory studies, the group will continue to maintain a broad perspective across the CLL pathway, including complications of CLL (e.g. Richter’s transformation, infection risk studies) and continue to investigate related and rarer subtype leukaemias such as  TPLL and HCL.

2.5 Feasibility and Sustainability

Designing trials that are realistic for NHS delivery, with appropriate site capacity, comparator arms, and resource modelling. Sustainability will depend on collaborative funding models and on supporting Early Career Researchers (ECRs) to participate in leadership and translational roles.

Each priority translates the overarching principles of the UK CLL Study Group into practical goals for 2026–2030. Together they provide a roadmap for delivering personalised, MRD-guided, and patient centred research that is feasible across the UK network.

Priority 1 – Personalised, Risk Adapted Care

Aim: To embed MRD driven, biology adapted therapy as the foundation of UK CLL trial design.

Objectives

• Develop adaptive, time limited treatment strategies that use MRD status to determine duration and escalation.
• Support NICE adoption of MRD-guided ibrutinib + venetoclax (I + V) as a standard UK approach, informed by FLAIR and other MRD driven data.
• Design next generation protocols exploring early intensification or consolidation with existing and newer agents including targeted therapies, antibodies and immunotherapy approaches.
• Incorporate biological stratification e.g. genomic risk (e.g., TP53, mutational status) and comorbidity into eligibility and stratification frameworks.

Priority 2 – Embedding Patient Experience and PPIE in UK CLL Trials

Aim: Ensure that patient experience and quality of life outcomes are embedded at every level of trial design.

Objectives

• Incorporate and/or conduct specific trials in patient reported outcomes, fatigue, infection, and other patient-centred outcomes
• Strengthen structured and CLL appropriate PPIE (Patient & Public Involvement and Engagement) from concept stage to publication.
• Maintain a trained and supported patient representative panel aligned to each active study.
• Collaborate with patient organisations to co-develop educational and trial awareness materials.

Priority 3 – Precision and Translational Integration

Aim: Maintain a national translational infrastructure linking clinical outcomes with scientific outputs.

Objectives

• Maintain a unified UK CLL Biobank Network, integrating the Liverpool Biobank with trial specific collections.
• Standardise access, governance, and cost recovery processes to facilitate academic and industry use.
• Prioritise correlative sub-studies investigating all aspects of CLL biology including MRD biology, resistance, and immune-microenvironmental mechanisms.
• Promote UK biobank visibility through international meetings.

Priority 4 – Scope Across the CLL Pathway

Aim: Focus on front line MRD-guided and relapsed/refractory trials while maintaining complementary early intervention and infection risk programmes.

Objectives

• Deliver at least one new front line MRD-guided trial and one relapse trial by 2028.
• Build on recent delivery of STELLAR for Richter’s transformation
• Support smaller early intervention and infection risk studies addressing prevention and survivorship.
• Ensure inclusion of frail, immunocompromised, and underserved patient groups across all designs.
• Maintain a portfolio of non CLL indications such as HCL, T-LGL and T-PLL.
• Encourage cross trial learning between “active surveillance” front-line, and relapse settings.

Priority 5 – Feasibility, Workforce and Sustainability

Aim: Guarantee the long term viability of UK CLL research through deliverable design, ECR development, and mixed funding sustainability.

Objectives

• Explore an ECR mentorship programme through the Forum and in partnership with the BCUK Haematology Research Network.
• Encourage ECR co-investigator representation on all Study Group endorsed proposals.
• Develop transparent, multi source funding partnerships spanning academic, charitable, and industry sectors.

The Strategic Aims outlined above provide the framework for activity across 2026–2030.

4.1 Oversight

• The UK CLL Study Group will continue to operate under the remit of the UK CLL Forum (see appendix), aligning with the Blood Cancer UK (BCUK) Haematology Research Network where appropriate
• The Chair and Deputy Chair will ensure alignment between trial development, translational research, and patient engagement.
• Small, flexible working groups will meet as needed to progress agreed concepts such as MRD-guided strategy, relapse/refractory studies, biobanking, mentorship, and PPIE.
• Participation in all activities will remain voluntary and open to new contributors from across the UK.

4.2 Monitoring and Reflection

• Annual Review: Progress against the aims will be discussed each October at the Study Group Meeting.
• Indicators of progress may include new trial activations, publications, biobank use, and evidence of ECR and PPIE engagement, but there will be no formal performance reporting.

4.3 Communication and Collaboration

• Maintain regular dialogue through meetings, and the UK CLL Forum.
• Ensure links with NHS R&D teams, CTUs, and CRN Haematology to support delivery feasibility.
• Charitable and patient engagement e.g. with BCUK, CRUK, CLLSA and Leukaemia UK.
• Continue international engagement through organisations such as IWCLL, EHA including ERIC ASH and related consortia.
• Work with pharma partners as appropriate

4.4 Sustainability

• Seek balanced support from academic, charitable, and non-promotional industry partners.
• Build sustainability into each new proposal through realistic site capacity and cost-recovery planning.
• Encourage Early Career Researchers to contribute to leadership and translational activities as part of long-term capacity building.

4.5 Future Review

This document will be regularly reviewed to remain relevant to emerging science, policy, and NHS priorities.
The next formal update is aimed to be achieved during 2028.

This strategy provides a shared framework with its success depending on continued goodwill, collaboration, and commitment to delivering high quality, patient centred CLL research across the UK.