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In the second part of three interviews from the 2015 American Society of Hematology annual meeting with Dr. Stephan Stilgenbauer from the University of Ulm, he discusses the criteria that predicts resistance to ibrutinib in relapsed and refractory patients with 17p deletion. These are traditionally the worst of the worst patients.
TAKE AWAY POINTS:
- In the past, relapsed and refractory patients with deletion 17p have had a terrible prognosis.
- Most of those patients will now have good durable responses to ibrutinib and idelalisib.
- The addition of other novel poor prognostic markers such as NOTCH1, BIRC3, and SF3B1 to the deletion 17p did not increase the risk of relapse.
- Bulky nodes (>5cm in diameter at baseline) did increase the likelihood of a poor response to ibrutinib in these patients with deletion 17p, but still most had good responses.
Until we had the new novel therapies, when we discussed relapsed and refractory patients with deletion 17p, we were discussing patients with very limited options with mostly poor outcomes. Now, the majority, but not all of these patients will do very well with durable remissions. Dr. Stilgenbauer’s research was to identify further risk factors that increased the risk of a poor outcome, even with the novel therapies.
Here is a link to the ASH abstract. The news is encouraging.
Please enjoy the interview that reviews this important paper
Brian Koffman, MD 3/7/16