Venetoclax has been added to the Pharmaceutical Benefits Scheme in Australia for use as a retreatment for CLL/SLL

[CLLerinOz]

In more good news, today the Pharmaceutical Benefits Scheme (PBS) in Australia added venetoclax to its listings for the retreatment of CLL/SLL in those whose disease relapses/progresses after an initial venetoclax-based therapy has controlled it.

The PBS Listing states:

"Chronic lymphocytic leukaemia (CLL)

Treatment Phase: Dose titration occurring at the start of treatment for relapsed/refractory disease

Clinical criteria:

The condition must have relapsed or be refractory to at least one prior therapy,

AND

The treatment must be the sole PBS-subsidised therapy for this condition,

AND

The treatment must only be prescribed for a patient with active disease in accordance with the International Workshop on CLL (iwCLL) guidance (latest version) in relation to when to prescribe drug treatment for this condition.

Treatment criteria:

Patient must not be undergoing retreatment with this drug where prior, active treatment of CLL/SLL with this same drug was unable to prevent disease progression."

pbs.gov.au/medicine/item/11...

This letter to the ASH publication Blood Advance in August 2022 ("Venetoclax retreatment of patients with chronic lymphocytic leukemia after a previous venetoclax-based regimen") provides some more information about the rationale behind the use of venetoclax as a retreatment for CLL/SLL.

ashpublications.org/bloodad...

CLLerinOz

[Shooey]

Good news indeed!

Unless I’ve missed something over the last few months UK patients are not able to receive further treatment with Venetoclax even though it may well have been successful for them in the past.

I specifically asked my consultant this question 12 months ago and was told, no, when my remission comes to an end Venetoclax will not be an option, non committal when I asked if cost was the reason.

Would be pleased to hear if anyone has any further information.

Best wishes

Shooey

[Kiwidi in reply to Shooey]

This is groundbreaking news for Australian patients along with the funding of zanubrutinib as a first line treatment. I think it might push Australia to the forefront in gold standard treatment.

[Shooey in reply to Kiwidi]

Great news for all down under, let's hope other countries follow in due course

[GD-K in reply to Shooey]

That is strange. i have been taking Ibrutanib for 2 years and now moving to Venetoclax . Start next week!

[Shooey in reply to GD-K]

Hi, currently in the U.K. we can’t have a second treatment with V , not relevant if you had IB before and this is your first treatment with V. Raised this again with my consultant last month and in his opinion we will probably, eventually follow australia and allow further treatments with V if proved previously successful. Fingers crossed he’s right!!!!

[Skyshark in reply to Shooey]

Venetoclax monotherapy is considered end of life treatment in UK since June 2022. 15 months ago but it takes time for some hospitals to catch up.

nice.org.uk/guidance/ta796

Seems to have a 2 year limit.

royalsurrey.nhs.uk/download...

or how Clatterbridge Manchester proceed seems to allow more repeats. Key to having further Venetoclax treatments is that you can't have progressed while on a prior Venetoclax therapy.

clatterbridgecc.nhs.uk/appl...

The usual 2nd line is Venetoclax + Rituximab (since 2019), according to the the Clatterbridge link above this can be repeated if remission duration was good.

nice.org.uk/guidance/ta561

I'm hoping that by the time I need it, AVO or BOVen (B=zanu) will be on 2nd line. AVO may be UK's 1st line "gold standard" by end of next year.

[Shooey in reply to Skyshark]

Hi, yes, I had V and R as second line and so far, touch wood three years in remission .

Hoping I won’t need to start investigating options for a while yet but we never know what’s round the corner do we.

Let’s hope you won’t need to find out for a while either.

Shooey

[onu1tadi2]

Update by Columbia university Irving medical center on CLL treatment