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Ibrutinib (a Bruton’s tyrosine kinase inhibitor) and venetoclax (a BCL2 inhibitor) are both highly effective and tolerable treatments for chronic lymphocytic leukemia (CLL). However, over time patients can stop responding to these therapies, and there are even some patients that have developed resistance to both of these drugs. Once a patient is double refractory, there are still approved treatment options, but none have been shown to be highly effective. Thus, patients may want to consider other options such as clinical trials with novel agents or cellular therapies such as CAR-T.
Dr. Brian Koffman spoke with Dr. Kerry Rogers, Assistant Professor and Hematologist in the Division of Hematology at Ohio State University, about an upcoming phase I clinical trial of VIP152, a new cyclin-dependent kinase 9 (CDK9) inhibitor for patients with double refractory CLL or Richter syndrome.
CDK inhibitors work by interfering with the cell cycle pathway which is necessary for cell growth and division. Because inhibiting such an important pathway causes rapid death of cancer cells, CDK inhibitors can cause tumor lysis syndrome. However, thanks to our experience with venetoclax, clinicians are now pretty experienced at how to monitor for and treat tumor lysis syndrome. More information on the clinical trial of VIP152 is below. Because it is a phase I study, it will require a lot of visits and monitoring to make sure that you are safe while taking this new drug.
Study: A Study to Evaluate VIP152 in Subjects with Relapsed/Refractory Chronic Lymphocytic Leukemia or Richter Syndrome
Main research question: Is VIP152 safe and tolerable for patients, and what is the maximum tolerated dose?
Study Type: Phase I clinical trial
Patients: 1) Patients with CLL who are refractory to or progressed on 2+ treatment regimens including a BTK inhibitor and venetoclax, OR 2) Richter syndrome
Intervention: Weekly IV infusion (30 minutes) of VIP152 for 21-day cycles
More information: https://clinicaltrials.gov/ct2/show/NCT04978779
Please enjoy this brief interview with Dr. Rogers.
Take care of yourself first.
Ann Liu, PhD