Research into chronic lymphocytic leukaemia (CLL)

All cancer treatments must be fully researched before they can be used for everyone. This is so we can be sure that:

• they work

• they work better than the treatments already available

• they are safe

To make sure the research is accurate, each trial has certain entry conditions for who can take part. These are different for each trial.

Hospitals do not take part in every clinical trial. Some trials are only done in a small number of hospitals, or in one area of the country. You may need to travel quite far if you take part in these trials. 

Go to Cancer Research UK’s clinical trials database if you are looking for a trial for CLL in the UK. You need to talk to your specialist if there are any trials that you might be able to take part in.

Many of these clinical trials are also for people with small lymphocytic lymphoma (SLL).

Some of the trials on this page have now stopped recruiting people. It takes time before the results are available. This is because the trial team follow the patients for a period of time and collect and analyse the results. We have included this ongoing research to give examples of the type of research being carried out in CLL.

Research into the causes of CLL

Researchers want to understand more about the causes of CLL. They are looking at samples of blood, bone marrow and saliva from people with CLL. They are also asking them about their family history of CLL. 

The researchers want to identify genes that could increase the risk of CLL. They also want to understand more about changes to certain genes, proteins, and sugars. And how these changes could affect how CLL develops. This might help doctors develop new treatments for CLL in the future.

Research into how CLL develops and changes

CLL can develop very slowly, and you might not need treatment. But for some people, CLL can progress more quickly, and you need treatment to control it. 

Researchers are looking for factors (markers ) that might help them predict whose CLL is more likely to progress. And who might need treatment. This might help doctors identify people who would benefit from certain types of treatment. Or benefit from treatment at an earlier stage. And it might also help doctors reassure people whose CLL is unlikely to progress.

Richter’s syndrome

Chronic lymphocytic leukaemia (CLL) can sometimes develop into a condition called Richter’s syndrome. Doctors also call this Richter transformation. Richter's syndrome means that the CLL changes (transforms) into a type of lymphoma.

Researchers are interested in improving treatment for people with Richter’s syndrome. They are looking at adding the targeted cancer drug acalabrutinib to standard treatment . They want to see if this works better.

Research into treatment for CLL

Researchers are looking at how to improve treatment for CLL. This includes improving treatments we already use. And seeing if new treatments work better than those we already have.

Using current treatments in different ways

The first treatment you have is called first line treatment. CLL tends to come back (relapse), and you might need more treatment. The next treatment you have is called second line treatment. You usually have different drugs for your second line treatment. Researchers want to know how well it works to treat people who relapse with the same drugs they had as first line treatment.

Treatment depending on measurable residual disease (MRD) results

Measurable residual disease (MRD) is the term for the small amount of cancer cells that are left after leukaemia treatment. It is also called minimal residual disease. Researchers are looking at further treatment depending on MRD levels.

Treatment breaks

People with CLL often take a targeted cancer drug called ibrutinib. You usually take it every day until there are signs that the CLL has come back. This might be for several years. There is some evidence that leukaemia is more likely to become resistant to ibrutinib if you take it for several years. Researchers want to know if taking breaks in ibrutinib treatment would stop or reduce the chance of this happening.

New drugs

Doctors are looking at new cancer drugs to treat CLL. Some of this research is at an early stage, which means the team are looking at the safety and dose of the drug. And they are finding out more about the side effects.

Some of these drugs are being looked at on their own or in combination with other cancer drugs. Some are for first treatment for CLL. Others for CLL that has not gone away with treatment or has come back after treatment.

New drugs in trials for CLL include:

• nemtabrutinib

• pirobrutinib

• epcoritamab

• zilovertamab vedotin

• NVG-111

• ABBV-101

• BGB-16673

• NX-5948

• iopofosine

• ABBV-525

Research into living with CLL

Doctors know that people with cancer can benefit from a healthy diet and exercise. But most of the research so far has been in people who have a solid cancer and not a blood cancer such as CLL. So, doctors are looking into if there is the same benefit for people with CLL.

Researchers are interested in the quality of life of people living with CLL. In many treatment trials, researchers find out about how the people taking part are feeling. They also ask questions about people’s day to day life and any symptoms they have.

This means researchers learn about how well the treatment works but also how it impacts people having treatment.