New leukaemia treatment hailed as ‘milestone' for patients
Scientists have hailed a 'milestone' in leukaemia care for patients after a UK trial found a chemotherapy-free approach to treatment may lead to better outcomes for some patients.
The groundbreaking UK-wide trial could reshape the way the most common form of leukaemia in adults is treated.
Researchers from Leeds wanted to assess whether two targeted cancer drugs could perform better than standard chemotherapy among patients with chronic lymphocytic leukaemia (CLL).
They led the Flair trial, which took place at 96 cancer centres across the UK.
Some 786 people with previously untreated CLL were randomly assigned to receive standard chemotherapy; a single targeted drug, ibrutinib, or two targeted drugs taken together, ibrutinib and venetoclax, with treatment guided by personalised blood tests.
They found that after five years, 94% of patients who received ibrutinib plus venetoclax were alive with no disease progression.
This compares with 79% for those on ibrutinib alone and 58% for those on standard chemotherapy, according to the study, which has been published in the New England Journal of Medicine and presented to the European Haematology Association congress in Milan, Italy.
Meanwhile 66% of patients on the new combination had no detectable cancer in their bone marrow after two years, compared with none of the people who received ibrutinib alone and 48% on chemotherapy.
Ibrutinib is a type of drug known as a cancer growth blocker.
It works by stopping signals that cancer cells use to divide and grow.
And venetoclax blocks the functions of a protein found in CLL cells.
Experts said that the new treatment regime was also tolerated better than traditional treatments.
Dr Talha Munir, consultant haematologist at Leeds Teaching Hospitals NHS Trust, who led the study said: 'Flair trial is a milestone.
'We have shown that a chemotherapy-free approach can be not only more effective but also more tolerable for patients.
'By tailoring individualised treatment based on how well the cancer responds, we're moving into an era of truly personalised medicine.'
Catherine Whitfield, 63, from Farnley, West Yorkshire, was diagnosed with CLL in 2018 after she noticed symptoms including bleeding gums, constant illness and neck pain.
She signed up to the trial, which was co-ordinated by the Leeds Cancer Research UK Clinical Trials Unit at the University of Leeds and sponsored by the University of Leeds.
She said: 'After three years of treatment, I am still MRD negative – that means no cancer cells.'
'I lost my husband to cancer. I have seen how hard it could be.
'My first thought after my diagnosis was, I will never see my grandchildren being born and growing up.
'Now I have two grandchildren, Drew and Alaia, and they are a delight and highlight the joys of a healthy life'.
Ms Whitfield added: 'The way this trial was explained, it just made sense.
'Also, the thought of chemotherapy was scary to me. The trial felt right. And it was.'
Dr Iain Foulkes, executive director of research and innovation at Cancer Research UK, which funded the trial along with AbbVie, and Johnson and Johnson, said: 'The results of the Flair trial show that we can provide kinder, more targeted treatment for chronic lymphocytic leukaemia, which gives people with CLL more precious time with their loved ones.
'We're hopeful that the results of the Flair trial will power new treatment options for leukaemia and other blood cancers, thanks to the efforts of researchers at in Leeds and across the UK working together on this trial.'
Chronic lymphocytic leukaemia is the most common form of leukaemia in adults.
There are about 4,000 new CLL cases in the UK every year.
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The best shoes for underpronation, according to podiatrists
Shoes for underpronation quick picks Walking shoes for underpronation: Altra Lone Peak 9 Hybrid shoes for underpronation: Topo Athletic Traverse Flat shoes for underpronation: Vivobarefoot Geo Court III Whether you've recently visited a podiatrist or self-assessed your gait patterns, those with underpronation often benefit from the best shoes tailored uniquely to their feet. Not sure where on the spectrum you stand? 'Underpronation is when the foot lacks pronation and the foot doesn't roll inward enough during the gait cycle,' Rina Harris, a functional podiatrist based in London, England, and a virtual practitioner at Gait Happens, said. Thus, she explained underpronation is not a medical diagnosis but rather a general term used to describe inefficient foot movement patterns that don't typically allow for shock absorption and efficient weight distribution. 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Read our review Altra Men's Lone Peak 9 For walking shoes that'll take you far in your quest for a healthier gait pattern, look to these supportive Altra sneakers Harris dubs some of the absolute best out there for walking with underpronation. Altra Women's Olympus 6 Trail Running Shoes In these hiking-friendly shoes ideal for those experiencing underpronation, enjoy a roomy toe box, grippy outsoles for maximum stability on slick terrain and mesh uppers for breathability. Altra Men's Olympus 6 Trail Running Shoes Hit the hills with style and comfort in one of Thompson's top hiking shoes for underpronators. 'It's a max-cushioned option for those needing extra protection on rugged terrain,' he said. Altra Women's Escalante 4 If you've got a need for speed, Thompson suggests the latest Altra Escalante runners, now even lighter than their predecessors. 'They're lightweight and flexible with moderate cushioning for comfort on longer runs,' he said. Altra Men's Escalante 4 In these expert-approved men's running shoes suitable for those with underpronation, a socklike fit ensures they move with — as opposed to against — your natural foot shape and gait Athletic Women's Traverse If you'll be experimenting with a variety of terrains during your next cardio session, opt for these do-it-all athletic trainers. 'They're hybrid shoes that work well for both trail running and hiking,' Thompson said. Topo Athletic Men's Traverse A low heel-to-toe drop and durable yet flexible mesh uppers keep these trail shoes best suited to underpronators. Better yet, they're available in wide sizing (men's only). Vivobarefoot Women's Geo Court III Harris approves of Vivobarefoot's casual tennis shoes for those experiencing underpronation. She appreciates them for the way they support natural foot movements all while offering a wide toe box and flexible soles to help encourage pronation and improve overall foot function. Vivobarefoot Men's Geo Court III Wear them with your favorite dress pants or athleisure set — the sky's the limit with this practical and versatile pair of men's flats suitable for those with underpronation. Tennis-inspired and made of responsibly sourced leather, they make for a smart addition to your footwear Athletic Women's Fli-Lyte 5 These trainers are one of Thompson's top picks because they offer protection without feeling overly rigid or sacrificing the foot's natural movement pattern. 'They're a good all-around choice for runners who want a natural feel with a bit of extra protection,' he said. Topo Athletic Men's Fli-Lyte 5 Thanks to their forefoot rocker design, you can expect these protective men's running shoes to impart serious momentum into your next run, allowing you to hit high speeds in comfort and with efficiency. Topo Athletic Women's ST-5 'This is a minimalist-inspired option ... that offers a balance between natural movement and just enough cushioning to help absorb impact forces, which can be higher in underpronators,' Thompson said. Topo Athletic Men's ST-5 The minimalist shoe bandwagon is worth hopping on if you're looking to help address underpronation, but with a bit of extra responsive foam at the midsoles, these pared-down shoes feel even more accessible. Feelgrounds Original Knit No specific activity on the itinerary, just vibes? Feel the ground with Feelground's catchall minimalist shoes. They're a podiatrist's pick for their ability to accommodate a range of movement patterns, thanks in part to a generous toe box and supple soles. 'They're another minimalist shoe with no cushioning but flexible and well shaped for everyday wear,' Thompson Shoes Women's HFS II If hitting personal records is on your radar, take Thompson's lead and invest in his performance-oriented pick boasting an anatomic fit that's also free of a heel-to-toe drop. Xero Shoes Men's HFS II Thanks to their contoured fit, extra-grippy soles, wide toe box and light-as-air feel, the newest HFS road runners from Xero Shoes offer underpronators an efficient and comfortable stride. Vivobarefoot Women's Primus Flow It's no secret heavy layers of cushioning can offset your balance during strength training, leading to muscular overcompensations and potential injury. That's what makes these expert-approved barefoot-like training shoes a wise addition to your footwear lineup. Vivobarefoot Men's Primus Flow Train the smart way with Thompson's favorite training shoes for underpronation. 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