On Feb. 12, 2014, ibrutinib was approved for the treatment of chronic lymphocytic leukemia (CLL) by the United States Food and Drug Administration (FDA) and with that the whole world of treatment for CLL took a giant leap forward.
But progress didn’t stop with that approval. In the past three years, we have seen many significant advances. We now have several strong options to knock back our cancer including ibrutinib, idelalisib, obinutuzumab, ofatumumab and venetoclax.
Ibrutinib’s approval has been broadly expanded for just about everyone with CLL.
Based on recent research, today we have a clear understanding of when and for whom chemo- immunotherapy (CIT) works and when and for whom it does not. For those for whom CIT does work, 6 months of treatment can offer deep responses lasting more than a decade.
We have several pure non-chemo treatments, we have novel agents and CIT combos, and we have clinical trials looking at new molecules and new combinations of novel therapies.
We have made unprecedented progress and we have great choices, to the point where many of us may soon be looking at a normal life expectancy.
It is a great time for those us with CLL, but we still have our work to do:
- There are still those of us whose CLL progresses or doesn’t respond despite access to the best and latest treatments.
- Some of us can’t tolerate our best therapies.
- Except in rare cases, none of us are cured.
- Many therapies require life-long treatment.
- Many therapies are extraordinarily expensive.
- Richter’s Transformation, a rare but serious complication too often carries a terrible prognosis.
- Too many of us still die of the complications due to our immune deficiencies or from our treatments including:
- Secondary unrelated cancers
- MDS (Myelodysplastic syndromes) and other blood cancers
- CLL is still misdiagnosed and may even be over-diagnosed, causing needless worries and stress for those who may have a normal life expectancy.
- Despite all the progress, because too many patients and too many providers don’t know about the latest treatments, too many are still not getting the best possible treatments.
That is why we at the CLL Society exist- because “Smart Patients Get Smart CareTM”.
Still this is a great time for those of us with CLL.
And a great time to reflect on how far we come in the last three years.
Brian Koffman, MD 2/14/17