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ERIC, the European Research Initiative on CLL held its first annual meeting in late October of 2018, not long before ASH.
I caught up with Dr. Wierda in Barcelona at the meeting to discuss the trials they are conducting at MD Anderson Cancer Center.
And it is all about combinations! At MDACC, they pride themselves on having a clinical trial available that is a good fit for any CLL patient that walks in the door.
- “Combination therapies” is the direction CLL research is moving to.
- For the small group of young fit patients with mutated IGVH and no bad prognostic markers, MDACC has a trial of combining ibrutinib with Fludarabine (F), cyclophosphamide (C) and Gazyva (G) or obinutuzumab.
- Just 6 weeks later I interviewed Dr. Jain about the very exciting early results that you can read here.
- 89% were U-MRD (undetectable minimal residual disease of < 1 on 10,000 cells) with IFCG versus 26% with FCR at 3 cycles.
- 100% of patients were U-MRD at 1 year and were able to stop the ibrutinib.
- For the majority of patients, there is no role for chemo so the best treatment option might be fixed duration therapies of 2 targeted oral agents, namely ibrutinib and venetoclax.
- While ibrutinib will offer the vast majority of patients years of remission when used alone frontline, it requires staying on the medication until disease progression or intolerance.
- These new non-chemo combos offer the possibility of being able to stop therapy, but when to stop is still a hot area of research.
The trials Dr. Weirda references are discussed in more detail elsewhere on the website when the results were published at ASH 2018 weeks later, but the big take away from this earlier interview is that the planning of these trials started by asking what patients needed and then tailoring studies to meet those needs.
Here is my interview from the 1st ever ERIC meeting in Barcelona, Spain in October, 2018 with Dr. Wierda:
Brian Koffman MDCM (retired) MS Ed
Co-Founder, Executive VP and Chief Medical Officer
CLL Society, Inc.