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Dr. Francesco Forconi of the University Of Southampton in the UK has a deep understanding of the nature of CLL and how we can best manage our cancer in the modern era of targeted therapies.
This brief VJHemOnc – Video Journal of Hematological Oncology video gives a helpful explanation of why the future for CLL patients includes the use of logical combination therapies.
The Clarity trial data on the efficacy of the combination of ibrutinib and venetoclax was one of the blockbuster presentations at ASH 2017. Dr. Forconi explains the biology behind that success.
Key Take Aways:
- The UK Clarity Trial showed remarkable responses to the combination of ibrutinib and venetoclax in relapsed and refractory CLL.
- All 25 patients assessed after 6 months of the combination have responded.
- 60% are in complete remission.
- 28% have achieved an MRD negative remission in the marrow.
- CLL cells have become dependent on B cell receptor (BCR) signaling, so blocking that with ibrutinib has a powerful benefit, but rarely fully controls the disease
- Venetoclax works by unblocking cell suicide (apoptosis) that the CLL cells have turned off, which leads to cell death, but if BCR signaling is still active it may work less well.
- The combination works synergistically and potently.
- Moreover, it is a strong combination, as ibrutinib is particularly effective at shrinking CLL in the nodes and venetoclax is powerful at clearing the CLL from the marrow.
Here is the VJHemOnc video with Dr. Forconi explaining more about the synergy:
Here is a link to the clinical data from the Clarity Trial presented at ASH 2017
Brian Koffman, MD 3-6-18