Venetoclax has been approved by the Scottish Medicines Consortium (SMC) for treating adults with CLL,who have already tried at least one treatment, in combination with another cancer medicine called rituximab. This is in line with the NICE decision for NHS England.
CLLSA submitted evidence to the SMC in support of this treatment which was considered by the experts reviewing the evidence.
What is interesting but perhaps not surprising about this document is that it is clear that venetoclax which is expected to be time limited is believed to be more cost effective than ibrutinib which is lifelong.
I think we may see quite rapid adoption of venetoclax plus rituximab as second line over and against ibrutinib and reserving ibrutinib until it is clear venetoclax therapy interrupted if remission occurs is not working well enough.
Of course if MRD undetectable status is as important early on in the disease as some experts now seem to believe this could actually be doing us all a favour.
But if ibrutinib really is in fact despite not typically getting us to MRD-U better at keeping us alive we may never know.
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