Thursday, July 18, 2024

CLL Community Urges Hospital Authority to List Next-Generation BTK Inhibitor on Drug Formulary to Bring Hope and Improve Quality of Life for CLL Patients

HONG KONG, June 25, 2024 /PRNewswire/ — Chronic Lymphocytic Leukaemia (‘CLL’) is a lymphoproliferative disease characterised by the abnormal proliferation of lymphocytes. The progression of CLL is relatively slow and it is a mild haematological malignancy. Cypress Charitable Trust is a Hong Kong government approved charity advocating for the betterment of the CLL community. As an independent organisation supporting CLL patients, Cypress Charitable Trust urged the Drug Advisory Committee under the Hospital Authority (‘HA’) to list the next-generation small molecule inhibitor of Bruton tyrosine kinase (‘BTKi’) on the HA Drug Formulary with safety net coverage. Adding the next-generation BTKi to the suite of therapies available through the HA will give CLL patients access to more options in their treatment regimen, while the next-generation BTKi’s efficacious treatment approach and fewer side effects will allow patients an improved survival outcome without compromising their quality of life.

Bruton tyrosine kinase (‘BTK’) is a protein molecule that plays an important role in promoting the growth and differentiation of B lymphocytes (‘B cells’). The use of targeted drugs to specifically inhibit the activity of BTK molecules can interrupt the transmission of cell messages and prevent the excessive proliferation of cancerised B cells.

The treatment goal of CLL is to improve patients’ overall response rate (‘ORR’), overall survival and progression-free survival, without compromising their quality of life. A clinical trial comparing the next-generation BTKi with the standard of care has found that the next-generation BTKi could effectively reduce the risk of progression and death and could improve ORR. The tolerability of BTKis is a major challenge faced by patients and their doctors as interruption or discontinuation of treatment may affect clinical outcomes. Clinical trial data indicate that treatment with the next-generation BTKi has a high tolerability. At the same time, the next-generation BTKi is notably effective, at least in sustaining or improving response rate from baseline, demonstrating that the next-generation BTKi may become a treatment option for patients with haematological malignancies who have developed tolerances to other BTKi treatments.

Another clinical trial comparing the next-generation BTKi with chemoimmunotherapy for previously untreated CLL patients over the age of 65 or patients with comorbidities has found that, as the first-line of treatment for CLL, the next-generation BTKi is more effective than traditional chemoimmunotherapy, with a reduction in the risk of progression and death of over 50%.

Mike Cheung, Founder of Cypress Charitable Trust, said, "CLL, a generally incurable and slow-growing blood cancer with higher incidence among adults aged over 50, demands a nuanced approach to treatment. The option of continuous therapy, which the next-generation BTKi can provide, is equally critical. Like many cancers, CLL has the potential to develop resistance to treatment. Continuous therapy options can be vital for patients who have developed resistance to initial treatments, for whom time-limited therapy is unsuitable, or for those who are able to maintain a regimen that suits their lifestyle and preferences without undue interruption. Therefore, we urge the Hospital Authority to include the next-generation BTKi in the formulary with safety net coverage, ensuring that all patients, regardless of their unique clinical circumstances, have access to the best possible care."

Dr. Herman Liu, Haematologist, said, "In 2021, 721 new cases of leukaemia were recorded in Hong Kong, while incidence rate per 100,000 persons was 9.7, both showing an upward trajectory.* Although the incidence rate of CLL is lower among Chinese, its biology, genetics, and treatment outcomes in Hong Kong patients have not been fully studied. It should be noted that clinical manifestations of CLL are diverse. Most CLL patients are asymptomatic at diagnosis and are only diagnosed from routine blood tests. The next-generation BTKi can prolong both overall survival and progression free survival.  Compared with the standard treatment approach, the next-generation BTKi leads to fewer cardiac disorders and less treatment discontinuation."

CLL is a type of leukaemia, accounting for 25% of all leukaemia.^ It is caused by malignant B lymphocytes occupying the middle of the bone marrow, then spread from the bone marrow to the blood. The malignant B lymphocytes take up the space for the growth of healthy red blood cells, white blood cells, and platelets in the bone marrow, causing anaemia and easy bleeding. Common CLL symptoms include swollen lymph nodes in the neck, underarms, and stomach, the feeling of fullness in the stomach, pain or swelling under the ribs, physical weakness and chronic fatigue, fever and prone to infections, night sweats, bruising, and weight loss.

* Website of Hong Kong Cancer Registry, Hospital Authority: www3.ha.org.hk/cancereg    

^ Kreuzberger, N., et al. (2020). Cochrane Database of Systematic Reviews, 2020(7), CD012022.    

About Cypress Charitable Trust
Established in April 2023, Cypress Charitable Trust (the ‘Trust’) is the first charitable organisation dedicated to providing support to Chronic Lymphocytic Leukaemia (CLL) patients in Hong Kong. Taking a patient-centric approach, the Trust strives to be a depository of information about CLL in Hong Kong. In addition to providing financial support to CLL patients, the Trust also promotes public awareness and education in the community of Hong Kong of CLL, including the publication of relevant up-to-date information on its website and organising public seminars.  

Source : CLL Community Urges Hospital Authority to List Next-Generation BTK Inhibitor on Drug Formulary to Bring Hope and Improve Quality of Life for CLL Patients

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