Despite the amazing progress in CLL in the last five years, there remain many urgent unsolved problems.
Dr. Thornton does a super job outlining the most pressing needs and I added one last wish to his list.
The unmet needs include:
- Gentle and effective frontline therapies for the majority of patients who are elderly (the average age at time of diagnosis is 72 years old), often with co-morbidities (unrelated medical conditions such as diabetes or renal or heart conditions) that may require special considerations and change in dosing for treatment for their CLL.
- Inexpensive and comprehensive prognostic and predictive testing, such as NEXT-GEN sequencing to help ensure all patients are getting their best choice of
- Better treatments for those of us whose chronic lymphocytic leukemia harbors a deletion of 17p or p53. Treatment for this group has markedly improved over the last years, but more durable therapies are still needed. Patients are still relapsing on the novel agents.
- Treatments that are of limited duration. When CLL therapy goes on for years, adherence falls off due to cost, side effects and just wanting to be off medications. Also long-term exposure to a drug might foster eventual development of a resistant clone. We need to be able to safely stop treatment.
- Richter’s Transformation, a rare but aggressive change in the CLL into a fast-moving, hard-to-control lymphoma, is still much too difficult to control for most patients.
- A CURE- that was my addition to the list of unmet needs. Beyond transplant, we need to be able to stop looking over our shoulders and say that we are cured. We need to be able to say that we used to have CLL.
It was a great privilege to be invited to CLL Ireland and meeting Dr. Thornton was one of the highlights.
Please enjoy our five-minute interview below or read the transcription here.
We still have our work to do, and we patients need to continuing pushing for more research and more resources to help meet these unmet needs.
We are all in this together.
Brian Koffman MD 10/17/17