{"id":28376,"date":"2022-10-01T09:00:31","date_gmt":"2022-10-01T09:00:31","guid":{"rendered":"https:\/\/news.cancerresearchuk.org\/?p=24715"},"modified":"2024-11-03T15:13:14","modified_gmt":"2024-11-03T15:13:14","slug":"new-treatment-for-waldenstroms-macroglobulinaemia-in-england","status":"publish","type":"post","link":"https:\/\/ogkologos.com\/en\/new-treatment-for-waldenstroms-macroglobulinaemia-in-england\/","title":{"rendered":"New treatment for Waldenstrom\u2019s macroglobulinaemia in England"},"content":{"rendered":"<div><img decoding=\"async\" src=\"https:\/\/news.cancerresearchuk.org\/wp-content\/uploads\/2022\/09\/Microscopic-image-of-a-low-grade-non-Hodgkin-lymphoma.jpg\" class=\"ff-og-image-inserted\"><\/div>\n<p><span data-contrast=\"none\">The National Institute for Health and Care Excellence (NICE) <\/span><a href=\"https:\/\/www.nice.org.uk\/guidance\/gid-ta10705\/documents\/final-appraisal-determination-document\"><span data-contrast=\"none\">has recommended<\/span><\/a><span data-contrast=\"none\"> zanubrutinib <\/span>(Brukinsa) <span data-contrast=\"none\">as an option for treating some people with <\/span><a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/non-hodgkin-lymphoma\/types\/low-grade?_gl=1*tq2891*_gcl_aw*R0NMLjE2NjI3MzY5MDkuRUFJYUlRb2JDaE1JaVlfODBZR0ktZ0lWU2UzdENoMk1uZ3BHRUFBWUFTQUJFZ0s3cXZEX0J3RQ..*_gcl_dc*R0NMLjE2NjI3MzY5MDkuRUFJYUlRb2JDaE1JaVlfODBZR0ktZ0lWU2UzdENoMk1uZ3BHRUFBWUFTQUJFZ0s3cXZEX0J3RQ..*_ga*MTMyMDQ0OTIzOC4xNjYxODY3ODEw*_ga_58736Z2GNN*MTY2MzkzMzU3My42OC4xLjE2NjM5MzUwNTQuMzQuMC4w&amp;_ga=2.165798974.166523074.1663662414-1320449238.1661867810&amp;_gac=1.207957542.1662736913.EAIaIQobChMIiY_80YGI-gIVSe3tCh2MngpGEAAYASABEgK7qvD_BwE\"><span data-contrast=\"none\">Waldenstrom\u2019s macroglobulinaemia<\/span><\/a><span data-contrast=\"none\"> (WM), a rare type of non-Hodgkin lymphoma (NHL) that develops in white blood cells. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">Zanubrutinib is now the first WM drug NICE has recommended for routine NHS use in England. It is likely that the decision will also apply to Wales and Northern Ireland. <\/span><\/p>\n<p><span data-contrast=\"none\">After comparing zanubrutinib to the main treatments currently used by NHS England, the NICE committee concluded that it was clinically effective and may help people with WM live longer and have a better quality of life<\/span><\/p>\n<p><span data-contrast=\"none\">In making its decision, the committee called the routine use of zanubrutinib a \u201cstep-change\u201d in managing WM.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p><span class=\"TextRun SCXW257199682 BCX0\" lang=\"EN-GB\" xml:lang=\"EN-GB\" data-contrast=\"none\"><span class=\"NormalTextRun SCXW257199682 BCX0\">Kruti Shrotri, Head of Policy Development at Cancer Research UK, said: \u201cThis decision is good news for people affected by <\/span><span class=\"NormalTextRun SpellingErrorV2Themed SCXW257199682 BCX0\">Waldenstrom\u2019s<\/span> <span class=\"NormalTextRun SpellingErrorV2Themed SCXW257199682 BCX0\">macroglobulinaemia<\/span><span class=\"NormalTextRun SCXW257199682 BCX0\">. Current treatment options include chemotherapy and immunotherapy, but these can severely impact people\u2019s quality of life. Patients told NICE they would therefore value more treatment options.\u201d<\/span><\/span><span class=\"EOP SCXW257199682 BCX0\" data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<h2 aria-level=\"2\">A different approach to Waldenstrom\u2019s macroglobulinaemia<\/h2>\n<p><span data-contrast=\"none\">WM (sometimes called lymphoplasmacytic NHL) is an incurable type of low grade NHL. \u2018Low grade\u2019 means it grows slowly.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">These low grade lymphomas usually affect a type of white blood cell called B cells, which, when healthy, create antibodies that help the immune system fight viruses and bacteria. In WM, abnormal B cells fill up the bone marrow or enlarge the lymph nodes or spleen.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">Zanubrutinib is designed to interrupt this process by blocking an enzyme called Bruton\u2019s tyrosine kinase (BTK). <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">BTK helps B cells, including the cancerous ones in people with WM, grow and survive, so targeting it can stop the cancer from growing. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">This is different from the 2 primary treatments currently available on the NHS in England, which kill cancer cells directly or guide the immune system to do so.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<h2 aria-level=\"2\"><span data-contrast=\"none\">Considering the evidence<\/span><span data-ccp-props=\"{&quot;134245418&quot;:true,&quot;134245529&quot;:true,&quot;201341983&quot;:0,&quot;335559738&quot;:40,&quot;335559739&quot;:0,&quot;335559740&quot;:259,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/h2>\n<p><span data-contrast=\"none\">NICE recommended zanubrutinib after considering the findings of the <\/span><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/32731259\/\"><span data-contrast=\"none\">ASPEN study<\/span><\/a><span data-contrast=\"none\">, a randomised phase 3 clinical trial that compared zanubrutinib with <a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/cancer-in-general\/treatment\/cancer-drugs\/drugs\/ibrutinib\">ibrutinib (Imbruvica)<\/a>, an older kinase inhibitor <a href=\"https:\/\/news.cancerresearchuk.org\/2021\/12\/16\/ovarian-bowel-and-non-hodgkins-lymphoma-treatments-approved-for-nhs-use-in-scotland\/\">used routinely by the NHS in Scotland<\/a>. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">Those results showed that 28% of people with WM treated with zanubrutinib (29 out of 102) had almost no signs of cancer after 20 months of treatment. This was more than the 19% of people treated with ibrutinib (19 out of 99), but not by enough to be statistically significant. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">Nonetheless, the study found that \u201czanubrutinib treatment was associated with a trend toward better response quality and less toxicity\u201d.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><a href=\"https:\/\/news.cancerresearchuk.org\/2022\/05\/23\/nice-doesnt-recommend-ibrutinib-drug-for-those-with-waldenstroms-macroglobulinaemia\/\"><span data-contrast=\"none\">As ibrutinib is not approved by NICE for the treatment of WM<\/span><\/a><span data-contrast=\"none\">, the ASPEN findings were indirectly compared with the results of 2 separate studies. These evaluated the combinations of chemotherapy and immunotherapy most often used by the NHS in England: <\/span><a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/cancer-in-general\/treatment\/cancer-drugs\/drugs\/bendamustine\"><span data-contrast=\"none\">bendamustine<\/span><\/a> <span data-contrast=\"none\">plus <\/span><a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/cancer-in-general\/treatment\/cancer-drugs\/drugs\/rituximab\"><span data-contrast=\"none\">rituximab<\/span><\/a><span data-contrast=\"none\"> (BR), and <\/span><a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/cancer-in-general\/treatment\/cancer-drugs\/drugs\/steroids\"><span data-contrast=\"none\">dexamethasone<\/span><\/a><span data-contrast=\"none\"> plus rituximab and <\/span><a href=\"https:\/\/www.cancerresearchuk.org\/about-cancer\/cancer-in-general\/treatment\/cancer-drugs\/drugs\/cyclophosphamide\"><span data-contrast=\"none\">cyclophosphamide<\/span><\/a><span data-contrast=\"none\"> (DRC).<\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">Conclusive information on how effectively zanubrutinib can help people with WM over the long term was not available at the time of the decision. Even so, the committee agreed that people with WM may live longer and have a better quality of life with zanubrutinib than with BR or DRC. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:0,&quot;335559739&quot;:160,&quot;335559740&quot;:240}\"> <\/span><\/p>\n<h2 aria-level=\"2\"><span data-contrast=\"none\">The potential for improved quality of life<\/span><span data-ccp-props=\"{&quot;134245418&quot;:true,&quot;134245529&quot;:true,&quot;201341983&quot;:0,&quot;335559738&quot;:40,&quot;335559739&quot;:0,&quot;335559740&quot;:259}\"> <\/span><\/h2>\n<p><span data-contrast=\"none\">One of the key reasons for improved quality of life is that zanubrutinib is a pill that people can take without going to the hospital for infusions. It also tends to cause less debilitating side effects than chemoimmunotherapy.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">A patient expert who spoke to the NICE committee explained that, after significant issues with chemoimmunotherapy, zanubrutinib had enabled him to return to the activities he enjoyed before his WM diagnosis.<\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p>NICE recommends that the drug should now be a treatment option for people with <span data-contrast=\"none\">WM who have had at least 1 previous therapy and are also suitable for treatment with BR. <\/span><\/p>\n<p><span data-contrast=\"none\">The Welsh government has directed the NHS in Wales to make medicines available within 2 months of NICE recommendations. As such, a<\/span><span data-contrast=\"none\">n estimated 300 people with WM across England and Wales should soon be eligible to receive zanubrutinib. <\/span><span data-ccp-props=\"{&quot;201341983&quot;:2,&quot;335559739&quot;:160,&quot;335559740&quot;:240,&quot;469777462&quot;:[4680,9360],&quot;469777927&quot;:[0,0],&quot;469777928&quot;:[3,4]}\"> <\/span><\/p>\n<p><span data-contrast=\"none\">NICE decisions are also usually adopted in Northern Ireland. The Scottish Medicines Consortium (SMC), which fulfils a similar role to NICE for the NHS in Scotland, recently decided not to recommend zanubrutinib for use there, concluding that the drug\u2019s potential health benefits were outweighed by its costs.<\/span><\/p>\n<p><h3 class=\"panel-title\">More on this topic<\/h3>\n<\/p>\n<p><a href=\"https:\/\/news.cancerresearchuk.org\/2022\/10\/01\/new-treatment-for-rare-lymphoma-waldenstroms-macroglobulinaemia-in-england\/\">Source<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>The National Institute for Health and Care Excellence (NICE) has recommended zanubrutinib (Brukinsa) as an option for treating some people with Waldenstrom\u2019s macroglobulinaemia (WM), a rare type of non-Hodgkin lymphoma (NHL) that develops in white blood cells. Zanubrutinib is now the first WM drug NICE has recommended for routine NHS use in England. It is [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"footnotes":""},"categories":[5137],"tags":[],"class_list":["post-28376","post","type-post","status-publish","format-standard","hentry","category-world-news"],"_links":{"self":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28376","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/comments?post=28376"}],"version-history":[{"count":1,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28376\/revisions"}],"predecessor-version":[{"id":44835,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/posts\/28376\/revisions\/44835"}],"wp:attachment":[{"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/media?parent=28376"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/categories?post=28376"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ogkologos.com\/en\/wp-json\/wp\/v2\/tags?post=28376"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}