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There is much reason to be optimistic as a CLL patient as we come to end of another year of great advances to treat CLL:
- Almost 5 years ago in early 2015, CLL was recognized by ASCO (American Society of Clinical Oncology) as the Cancer Advance of the Year due to all the rapid progress in treatments in 2014.
- Since 2014, we have had 6 amazing new drugs approved to treat CLL:
- Ofatumumab (anti-CD20 antibody)
- Obinutuzumab (anti-CD20 antibody)
- Ibrutinib (blocks the B-cell receptor by blocking BTK)
- Idelalisib (blocks the B-cell receptor by blocking PI3K)
- Duvelisib (blocks the B-cell receptor by blocking PI3K)
- Acalabrutinib (blocks the B-cell receptor by blocking BTK)
- To give some perspective, there have been no new breakthrough drugs approved to treat MDS (myeloid dysplastic syndromes) in over a decade.
- We have multiple new drugs and combinations of drugs in human trials now that should improve care even more including:
- New generations of all the existing drugs listed above that look to improve the safety and/or the efficacy of these existing drug.
- New “reversible” BTK inhibitors that promise to overcome the main cause of ibrutinib resistance.
- New ways to block the B- cell receptors that are different that the existing BTK and PI3K inhibitors.
- New drugs to degrade BTK.
- New drugs that block key proteins from leaving the nucleus of the cell, effectively killing the cancer.
- New drugs that modulate the immune system or the micro-environment.
- New targets for new antibodies including CD19
- CAR-T and other cellular therapies.
- Multiple new combinations of old and new drugs that are offering very deep responses and in some cases, the option to stop therapy.
It might be worth considering one of these clinical trials when you are weighing your treatment options. So many good choices.
Dr. Brian Koffman, a well-known retired doctor, educator, and clinical professor turned patient has dedicated himself to teaching and helping the CLL community since his diagnosis in 2005. He serves as the Executive Vice President and Chief Medical Officer of the CLL Society Inc.
Originally published in The CLL Society Tribune Q4 2019.