A common concern for people living with CLL/SLL is whether treatment increases the risk of developing another cancer. Recent research offers reassuring news.
Findings presented at the 2024 American Society of Hematology (ASH) Annual Meeting and summarized by the CLL Society suggest that modern first–line CLL/SLL treatments, including targeted oral therapies and monoclonal antibodies, do not appear to increase the risk of other cancers compared with those patients under active surveillance (watch and wait). This marks an important shift from older, chemoimmunotherapy treatment approaches.
The study included more than 5,000 people with CLL/SLL from a large U.S. Veterans Affairs database. Patients were followed over time to determine whether they developed a second cancer, with outcomes compared betweenthose who received first-line therapy and those managed with active surveillance. Here are the key points:
- Most patients did not develop a second cancer during follow-up
About 90% of patients did not develop another cancer over an average follow-up of just over three years. - Modern treatments were not linked to higher cancer risk
Patients treated with first-line targeted therapies (such as BTK inhibitors like ibrutinib, acalabrutinib, and zanubrutinib, or venetoclax-based treatment) did not have a higher risk of second cancers compared with patients in active surveillance. - Older chemotherapy-based treatment showed higher risk
Initial treatment with chemoimmunotherapy was associated with anincrease in the incidence of other cancers compared to patients inactive surveillance. - Most second cancers reflected common age-related cancers
These included lung, prostate and gastrointestinal cancers which are also common in the general population.
Taken together, the findings are reassuring. They suggest that newer first-line treatments are not adding to the baseline risk of second cancers, which is already influenced by age, the disease itself and immune system changes.
It is important to remember that CLL can affect the immune system, which may increase vulnerability to infections and certain cancers over time. This risk varies widely between individuals and is influenced by many factors beyond treatment alone.
Overall, this research supports an encouraging message: modern CLL first-line therapies continue to improve outcomes without increasing the risk of second cancers.
This information does not replace medical advice. Patients are encouraged to speak with their healthcare team about their individual risk factors and treatment history.
For those who wish to learn more, see the full article including a link to the ASH abstract here. Additional information on CLL and secondary cancers can be found in CLL Canada’s Information and Resource Centre.