Post ASH 2016 CLL Patient Educational Forum: Dr. Rosen on New Options for Patients whose CLL Turns Bad

In our 2^nd annual post American Society of Hematology (ASH) CLL Patient Educational Forum held at City of Hope (COH) in Duarte, California in late Dec. 2016, I briefly interviewed Dr. Steve Rosen, Provost at COH.

Reflecting on the recent ASH meeting, Dr. Rosen was optimistic about the new therapies for CLL and especially on a new treatment option for those whose CLL transforms into a more aggressive type of lymphoma known as Richter’s Transformation (RT).

Take Away Points

• Until recently, for most, but not all patients, and short of a hematopoietic stem cell (bone marrow) transplant, the prognosis for Richter’s transformation has been grim.
• A new therapy using a checkpoint inhibitor (nivolumab) turns the body’s own immune system back on, no longer allowing the cancer to escape detection by the T cells, and resulting in dramatic responses.
• Options for treating CLL are improving fast and requires both the care of an up-to date CLL expert and the patient’s input regarding their treatment.

I am proud to say that the very trial that Dr. Rosen refers to is one for which we helped recruit patients. Please see the first trial listed here to read more about the rationale of the trial and to find information on enrollment.

You can read the abstract on Nivolumab Combined with Ibrutinib for CLL and Richter Transformation: A Phase II Trial presented at ASH 2016 here. Though the numbers are small, 2 of 4 patients with RT responded.

This is proof again about the importance of clinical trials. You can see on our website’s pages the progress from the trial’s announcement to the reporting of its early results.

For a deeper, but patient-friendly explanation of how checkpoint inhibitors (PD-1 and PDL-1 inhibitors) work, please listen to my recent interview with Dr. John Pagel found here.

For a nice overview of RT or Richer Syndrome as it is also called, I recommend the article by Dr. Adrian Wiestner that can be found here.

Thankfully RT is a rare problem in CLL, but it remains a significant unmet need. These new approaches are providing hope.

Please enjoy my brief interview with Dr. Rosen.

Thanks for reading this.

Brian Koffman, MD  1/31/17