In our wide-ranging interview from the CRC (Chronic Lymphocytic Leukemia Research Consortium) meeting in April 2015, we look at how to avoid ibrutinib resistance and some possible responses if it seems to be developing. Dr. Jeff Jones, one of the team of strong researchers out of Ohio State University shared his thoughts with me during a break.
Key Take Aways:
- Complex karyotype (and not 17p deletion) is the most important risk factor for developing ibrutinib resistance.
- Combination therapies will likely be necessary to prevent resistance.
- New tests may reveal a resistance mutation in a small population of chronic lymphocytic leukemia (CLL) cells long before a clinically important relapse occurs.
- If we see evidence of a mutation that suggests emerging ibrutinib resistance, that might be the time to initiate combination therapies.
- Trials are now ongoing to possibly change the “watch and wait” paradigm and to study whether early interventions can improve outcomes.
- More clinical trials are still needed to answer all these questions.
We are now well beyond the first flush of excitement about the trial data on the new drugs such as ibrutinib and idelalisib.
Dr. Jones clearly and simply discusses the ongoing research to address some of the critical unknowns and the unmet needs in CLL, including using combination therapies and finding ways to get us beyond controlling the disease and to be able to discontinue treatment without re-occurrence.
Wouldn’t that be great!
Here is the interview:
Brian Koffman 10/19/15