Daratumumab (subcutaneous injection) for multiple myeloma
Daratumumab injected under the skin (subcutaneous formulation) is in development for the treatment multiple myeloma (MM) as an alternative to currently approved daratumumab intravenous formulation. MM is a rare, incurable cancer of the plasma cells in the bone marrow where large amounts of abnormal plasma cells are produced and interfere with the production of platelets, red and white blood cells. People with MM will experience periods of time without symptoms followed by periods when the illness comes back (‘relapsed’ MM). Eventually the periods without symptoms will shorten and the illness will become immune to the drugs given to treat it (‘refractory’ MM).
Lenalidomide in addition to R-CHOP chemotherapy for diffuse large B-cell lymphoma
Lenalidomide in addition to a chemotherapy combination known as R-CHOP is in clinical development for newly diagnosed, previously untreated adult patients with diffuse large B-cell lymphoma (DLBCL) of the subtype known as activated B-cells (ABC) type. DLBCL is a cancer affecting a type of white blood cells called lymphocytes or B-cells. It is the most common form of non-Hodgkin lymphoma among adults. DLBCL is an aggressive cancer and although it can be cured in more than half of people affected, it remains a serious and life threatening disease. Treatment does not work as well for patients with the ABC type compared to patients with other DLBCL types who receive standard treatment.
Acalabrutinib for chronic lymphocytic leukaemia – first line
Acalabrutinib is a novel oral anti‐cancer drug in clinical development for people with chronic lymphocytic leukaemia (CLL) who have not received any previous treatment. 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 and 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 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.
Acalabrutinib for relapsed/refractory Chronic lymphocytic leukaemia
Acalabrutinib is a novel oral anti-cancer drug in clinical development for people with relapsed or refractory (R/R) chronic lymphocytic leukaemia (CLL) who have previously been treated (second line or greater). 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 and fight infection and stop the production of healthy blood cells. The disease is chronic and develops slowly. R/R CLL means the cancer has come back after treatment and reaching remission, or the cancer has failed to respond to treatment. Treatment options for R/R CLL include targeted therapy drugs, chemotherapy, radiation therapy or surgery.
Nivolumab in combination with ipilimumab for the adjuvant treatment of melanoma
Nivolumab in combination with ipilimumab is in development for the treatment of melanoma following surgery. Melanoma is a type of skin cancer which arises from the pigment cells (melanocytes) in the skin. One of the most important causes of melanoma is exposure to too much ultraviolet light in sunlight. Melanoma is considered to be the most serious type of skin cancer because it is more likely to spread from the skin to other parts of the body than other types of skin cancer. The primary treatment of melanoma is usually surgery. Additional (‘adjuvant’) treatment is usually recommended after surgery to reduce their chances of recurrence.
Nivolumab in combination with ipilimumab for malignant pleural mesothelioma – first line
Nivolumab in combination with ipilimumab is in development as first-line treatment in adult patients with unresectable malignant pleural mesothelioma (MPM). MPM is rare a type of cancer that affects the outer linings of the lungs and the internal chest wall. Mesothelioma is often diagnosed at an advanced stage and surgery is not always possible. Treatment is usually given to keep symptoms under control (palliative care) for as long as possible, although patients tend to respond poorly to current chemotherapy and radiation therapy.
Adstiladrin for high-grade, BCG unresponsive non-muscle-invasive bladder cancer
Adstiladrin is currently in clinical development for the treatment of patients with high-grade non-muscle-invasive bladder cancer (NMIBC). It is being developed particularly for NMIBC that is not responsive to Bacillus Calmette-Guerin (BCG) therapy, the current main treatment option for early bladder cancer. Bladder cancer starts in the inner lining of the bladder and the most common symptom is passing blood in urine. NMIBC is an early bladder cancer and is the most common type. High-grade NMIBC means the cancer is more likely to grow and spread quickly and also more likely to come back after initial treatment.
Nivolumab in addition to temozolomide and radiotherapy for MGMT-methylated glioblastoma in newly diagnosed adults – first line
Nivolumab is a type of immunotherapy that is currently licensed in the UK for the treatment of several types of advanced cancers such as melanoma, non‐small cell lung cancer, and kidney cancer. It blocks a protein called programmed death-1 (PD-1), which is found on the surface of a type of immune cells called T-cells. Blocking PD-1 stimulates the T-cells to kill the cancer cells. Temozolomide in combination with radiotherapy is currently licensed in the UK for newly diagnosed glioblastoma in adults. The addition of nivolumab to temozolomide and radiotherapy will potentially offer an additional first line treatment option for adult patients who are newly diagnosed MGMT-methylated glioblastoma.
Tabelecleucel for Epstein-Barr Virus-associated lymphoproliferative disease following solid organ transplant
Tabelecleucel is in clinical development for people with Epstein-Barr Virus (EBV)-associated post-transplant lymphoproliferative disease (PTLD) following solid organ transplant, where treatment with rituximab or rituximab and chemotherapy has not been successful. The EBV virus is present in around 90% of people, but people who have had an organ transplant need to take medicine that suppresses their immune system. This means that virus-infected lymphoid cells can grow more easily. The rapid increase in these lymphoid cells can result in lymphoma, a type of cancer. EBV-PTLD can be treated by reducing the immunosuppressive medicines, but may also need treatment with rituximab with or without chemotherapy.
Encorafenib in combination with binimetinib and cetuximab for BRAF V600E mutant metastatic colorectal cancer
Encorafenib in combination with binimetinib and cetuximab is one of the first regimens to target the BRAF V600E-mutation in colorectal cancer. When this mutation is present, it switches on another protein called MEK, which stimulates cell division and leads to uncontrolled cell growth. Encorafenib and binimetinib target different parts of an important signalling pathway in tumour cells with the mutation, and slows down their growth and communication. It is also one of the first combinations to simultaneously target the BRAF and MEK pathways, and encorafenib and binimetinib have the advantage of oral administration.