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Considering FCR? What You Should Know Before Starting Chemotherapy

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Published on June 19, 2018

How should cancer patients make treatment decisions with the various types of therapies available? For chronic lymphocytic leukemia (CLL) patients choosing their first-line treatment, comparing the risks and benefits with other modern, innovative strategies may help determine the most appropriate option. Are there other, equally effective, options besides chemotherapy? How will treatment impact quality of life? On location at CLL Live in Niagara Falls, Canada, Dr. Nicole Lamanna gives an expert perspective on what CLL patients should be aware of before starting an FCR chemotherapy regimen and discusses the alternative treatment routes. Dr. Lamanna also describes where clinical trial research is headed on frontline data and initial treatments for CLL. Watch now to learn more. 


Transcript | Considering FCR? What You Should Know Before Starting Chemotherapy

What's your take about that, because I know even now there are trials with venetoclax (Venclexta) and rituximab (Rituxan) or others and having no chemo?  

So I think anybody who you're considering—and, again, it's a small cohort—if you're considering FCR that group could also get ibrutinib.  So certainly until that data is available, and that will—there is frontline data that will be coming forth where, where what is the best therapy to get as your initial first-line treatment.  There's randomized trials that hopefully will give get the answer to that.  

When you talk about combinations there's no doubt.  So there are many folks that may be moving away in general from chemo immunotherapy, traditional chemo immunotherapy because of those reasons about late-term toxicities and so on and so forth.  And so there are lots of trials that were looking to see whether or not those combinations, A, will be as fruitful and beneficial where the long-term therapies—or I should say the long?term gain, either the response duration is very long or the overall survival is improved.  

I think we just need more data, but yes, there has definitely been a move in the clinical trial arena to sort of combine novel agents with antibodies or even just novel agents with novel agent to move away from chemo immunotherapy.  But there's lots of unanswered questions with that, too.  You know, how long do you continue the oral agents, the MRD-negative area that you brought up before, are we going to have people indefinitely on these pills for the rest of their lives?  What's the long-term toxicity 20 years of those agents, or can we abbreviate the oral agents?  

There are a lot of unanswered questions, but at least that frontline of what do you get as my first therapy, FCR versus let's say ibrutinib, at least it's a novel agent, that data at least that trial has been run, and we can see what that data shows. 

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