MONTHLY QUIZ: Concerning the reason we developed CLL:
1: CLL can be familial, but that is rare.
2: CLL incidence is increased in those exposed to Agent Orange in Vietnam and elsewhere.
3: CLL incidence is increased in those exposed to radiation from Chernobyl.
4: CLL is linked to benzene exposure.
5: All of the above.
6: 1, 2 and 3 are correct.
The correct answer is #6. CLL mostly occurs episodically with no known cause but occasionally CLL runs in families. Agent Orange is a recognized risk for CLL and exposed veterans who develop CLL may be entitled to compensation. Radiation was not considered a risk due to the lack of increase of CLL after Hiroshima, but we now know from the Chernobyl experience, that Hiroshima was the exception due to the very low baseline incidence in of CLL in ethnic Japanese. CLL is more common in Whites and Hispanics than Asians and Blacks. Usually, we don’t know why we got CLL.
NEWS:
- Join us on August 28th for the webinar, From Service to Support: Managing CLL / SLL in the Veteran Community.
- If you missed the webinar, Next-Generation CLL Treatments: Understanding Clinical Trials and Future Therapeutic Strategies, you can catch the replay on our education on-demand page.
- Season 2, episode 2 of the CLL Society Podcast, CareCast, is now live! Join lifelong athlete Ashley Montulli and CLL Society’s Development Director—and fellow CLL patient—Ron Katz for a powerful conversation on navigating life with CLL while balancing motherhood, fitness, and wellness.
- CLL Society’s Research Program is proud to announce three prestigious researchers for the Clinical Scholar Award, the Young Investigator Award, and the Integrative Medicine Award.
- Please share with your support groups that we have opened a support group interest survey for young people with CLL. For the purpose of this group, we define young people as those aged 55 and under.
- September 1st is World CLL Day. Watch the website and social media as we push to increase awareness of our rare cancer.
BASICS: Clinical Trials Phases – This applies to all trials, including those for CLL or any medical condition.
Phase 1: Is the drug safe and what’s the best dose? There is no placebo arm. These are small trials. While they are officially designed to check for safety, clearly efficacy is also looked for.
Phase 2: Does the drug work? Is it effective? Medium size trials where there may or may not be no placebo or control arms. There also can be different arms with different combinations or sequencing of the drugs.
Phase 3: Is it better than the standard of care? These are large trials where there is randomization to either a control arm of standard care or the new therapy. Only when there is no “standard of care,” there might be a placebo arm. This is almost never the case in CLL. Ask if the trial allows “crossover” so that if one progresses on one arm, one can transfer to the other. That’s important because it allows patients to get the benefit of the best treatment, no matter to which arm they were randomized. Phase 3 trials are often “pivotal trials” required by the FDA to decide whether to approve the treatment as a new standard of care.
Phase 4: What else do we need to know about this already approved drug or vaccine or treatment?
WORD OF THE MONTH: Heterogeneity
Heterogeneity is the quality of being diverse in character or content. CLL is a heterogenous disease as we are all different in how our disease progresses and is managed. We say at CLL Society: “If you know one CLL patient, you know one CLL patient.” In clinical trials and in statistics, the concept of heterogeneous populations is critical. Trials must compare “apples to apples.” One easy example is that you can’t compare relapsed CLL patients to frontline CLL patients from different trials. We are all different.
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