In the third part of my interview from ASH 2016 in San Diego, Dr. Wiestner from the NIH discusses who is most likely to become resistant to ibrutinib for their chronic lymphocytic leukemia (CLL).
Take Away Points
- As it does with FCR, deletion of the short arm of the 17th chromosome (del17p) in the CLL cells, predicts eventual resistance to ibrutinib.
- Complex karyotype (CK) also predicts resistance to ibrutinib.
- Patients with del17p who have had prior therapies, especially multiple prior therapies are at the highest risk.
- Still even high-risk patients often get two years or more of remission with ibrutinib.
- However, those whose chronic lymphocytic leukemia does relapse have options such as:
- Venetoclax
- Idelalisib
- CAR-T therapies
- SNS-062
- Others in early development
- Cure may be possible for some patients with CLL in the next few years.
Perhaps even more encouraging is that the near future might bring to most CLL patients a “functional cure” where their CLL is still present, but controlled and does not shorten or negatively impact their lives.
That is both a noble and attainable goal.
Here is my hopeful interview from ASH 2016 with Dr. Wiestner.
Enjoy.
Brian Koffman, MD 6/27/17
