Ibrutinib in addition to rituximab is being developed for young and fit untreated patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL). CLL is a type of cancer in which too many white blood cells are produced. As these cells develop abnormally, they are unable to function, fight infection and reduce the production of healthy blood cells. The disease is chronic and develops slowly. Treatment for CLL is complex and depends on a number of factors, including the extent of disease, previous treatment, patient’s age, symptoms and general state of health. Patients whose CLL is not causing any symptoms or is getting worse only very slowly may not need treatment. Treatment for CLL is started only if symptoms become troublesome.
Ibrutinib works against cancerous B lymphocytes, which are a type of white blood cells affected by these diseases. It does this by blocking an enzyme called Bruton’s tyrosine kinase (BTK), which promotes survival of B lymphocytes and their migration to the organs where these cells normally divide. By blocking BTK, ibrutinib decreases the survival and migration of B lymphocytes, thereby delaying the progression of cancer. Ibrutinib is available in tablets taken orally. If licensed, ibrutinib in addition to rituximab will offer an additional first-line treatment option for untreated young and fit patients with CLL or SLL.
Atezolizumab is currently in clinical development for the treatment of patients muscle-invasive urothelial cancer (MIUC) including muscle-invasive bladder cancer (MIBC) and upper tract urothelial cancer (UTUC) patients who are at high risk following resection. MIBC is a cancer that spreads into the thick muscle deep in the bladder wall. MIBC starts in the inner bladder layer and then grows in the deep muscle. While UTUC can arise along any part of the urinary tract lined with urothelium with the majority of cases in the lower tract and rest in the upper tract. Over time the tumour may grow outside the bladder into tissues close by and then may spread to lymph nodes, the lungs, the liver and other parts of the body. The current standard care of treatment includes a surgery which might not be adequate and some patients might be at high risk for recurrence.