A major breakthrough in leukaemia treatment has been achieved through a UK trial that demonstrated a chemotherapy-free approach could significantly improve outcomes for patients with chronic lymphocytic leukaemia (CLL). This landmark UK-wide study has the potential to revolutionize how the most common form of adult leukaemia is treated.
Led by researchers in Leeds, the Flair trial evaluated whether two targeted cancer drugs could outperform standard chemotherapy for patients with previously untreated CLL. Conducted across 96 cancer centres in the UK, the study involved 786 participants randomly assigned to one of three treatment groups: standard chemotherapy, a single targeted drug called ibrutinib, or a combination of two targeted drugs—ibrutinib and venetoclax—with treatment personalized based on blood test results.
After five years, results showed that 94% of patients receiving the ibrutinib and venetoclax combination were alive without disease progression. This was notably higher than the 79% survival rate with ibrutinib alone and just 58% with standard chemotherapy. Additionally, 66% of those on the drug combination had no detectable cancer in their bone marrow after two years, compared to none in the ibrutinib-only group and 48% in the chemotherapy group.
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Ibrutinib works by blocking signals that cancer cells use to grow and divide, while venetoclax inhibits a protein essential to CLL cell survival. Experts noted the new treatment was not only more effective but also better tolerated than traditional chemotherapy.
Dr Talha Munir, consultant haematologist at Leeds Teaching Hospitals NHS Trust and lead of the trial, said: “The Flair trial is a milestone. We have shown that a chemotherapy-free approach can be both more effective and more tolerable for patients. By personalizing treatment according to patient response, we are advancing into an era of tailored medicine.”
One participant, 63-year-old Catherine Whitfield from Farnley, West Yorkshire, was diagnosed with CLL in 2018 and enrolled in the trial. She described her experience: “After three years of treatment, I am still MRD negative—meaning no detectable cancer cells. Losing my husband to cancer made me fearful of what awaited me. I worried I wouldn’t live to see my grandchildren grow up. Now, enjoying time with my grandchildren, the trial has given me hope and a new lease on life.”
The trial was coordinated by the Leeds Cancer Research UK Clinical Trials Unit at the University of Leeds, with funding from Cancer Research UK, AbbVie, and Johnson & Johnson. Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, highlighted the significance: “The Flair trial’s results show we can offer kinder, more targeted treatments, granting people with CLL precious extra time with their loved ones. This success paves the way for new options in treating leukaemia and other blood cancers.”
Chronic lymphocytic leukaemia is the most prevalent form of leukaemia in adults, with around 4,000 new UK cases annually. This trial marks a turning point in treatment approaches, bringing hope to thousands of patients.