ERIC 2018: Dr. Stilgenbauer on Sequential and Combination Therapies in chronic lymphocytic leukemia (CLL)
I thought I would take a break from our ASH interviews and share my observations from the European Hematology Association Congress last month in Stockholm, Sweden.
Take Away Points:
- CAR-T is more developed and available in the USA than in Europe
- Minimal residual disease (MRD) negativity is probably an important indicator of a durable remission for chemo-immunotherapy, cellular therapy such as CAR-T and novel targeted therapies such as venetoclax.
- The flipside of this is that achieving a complete remission where all nodes shrink to ≦ 5 cmis probably not that critical. MRD is more important.
- Combinations are the future for most relapsed and high-risk patients. They include among others:
- Venetoclax and ibrutinib
- Venetoclax and rituximab
- Venetoclax and umbralisib
- FCR and ibrutinib
- FCR and duvelisib
- Ublituximab (TG- 1101) and umbralisib
In future posts, I will present on the various trials and also my EHA interview with Deb Sims and the CLL Society’s abstract and poster, but for now this is just an overview to point the direction for our next few updates.
Conclusions:
While frontline monotherapy with ibrutinib produces very strong and durable results, combinations will likely be needed for many CLL patients. And the deeper the remission the better the remission.
Here I am from EHA 2018. You can read the transcript here.
Stay strong
We are all in this together.
Brian Koffman
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