Dr. William Wierda from the MD Anderson Cancer Center was interviewed about the pipeline of new targeted therapies for CLL at the 18th International Congress On Hematologic Malignancies held in New York City in February 2014.
TAKE AWAY POINTS:
- The major groups of inhibitors target BTK or phosphatidylinositol 3-kinase (PI3K) or the spleen tyrosine kinase (Syk) or BCL2 proteins.
- These oral therapies for CLL are transforming treatment.
- They do not appear to be curative.
- Treatment options are changing fast.
ORAL TARGETED THERAPIES:
This nice interview by Targeted Oncology on how treatment for CLL is changing was published in May 2014. Much has happened since that time, but it still worth a look so I am recommending this link where he discusses in some detail the new oral therapies for CLL.
I agree with most of what Dr. Wierda has to say, but I take a somewhat dimmer view of the future role for chemotherapy for us CLL patients. I would also argue that there is strong data that argues for the use of ibrutinib front-line in 17p deletion evidenced by its approved by the FDA for that indication.
I like this interview as it shows the advantages of being able to stick with a topic and get to the more in-depth answers. He provides us with the information we patients need, but may not want to hear. This can mean learning that some research news is not to our liking, but could be to our advantage to know.
Below is a partial list of coming medications for CLL taken from Dr. Wierda’s presentation at 18th Annual International Congress on Hematologic Malignancies, February 2014 in New York City. There are many new trials that are not listed. Two of them (ibrutinib and idelalisib) are already approved, a few more are getting close, some are in early development and look promising in phase 1 trials, there are more to add to this list, and some of those included will never make it to market. Hopefully more and more therapies will be added to our armamentarium. We need more options. We need more combination and sequential therapies with targeted non-cytotoxic drugs. We need a cure.
Brian Koffman 5/29/14 Revised 3/17/15