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Can There Be Too Many CLL Treatment Options?

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Published on September 17, 2018

At a recent town meeting at The University of Texas MD Anderson Cancer Center, an audience member asks, “as the pace of progress accelerates and more treatment options become available, does this create a problem in getting clinical studies completed because there are so many potential combinations?” A panel of CLL experts including Dr. Nicole Lamanna, Dr. Michael Keating and Dr. Alessandra Ferrajoli explain how new avenues in research affect the treatment landscape for chronic lymphocytic leukemia (CLL) and discuss the challenge of choosing the most appropriate therapy for each individual patient.

Provided by CLL Global Research Foundation, which received support from AbbVie Inc., Gilead Sciences, Inc., Pharmacyclics LLC and TG Therapeutics. It is produced by Patient Power in collaboration with The University of Texas MD Anderson Cancer Center.

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Transcript | Can There Be Too Many CLL Treatment Options?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

Male Speaker:

Undoubtedly, the pace of progress has gotten tremendous, and all the new options and types of drugs and treatments coming out.

And, my question is, does that present a problem in getting clinical studies created and completed, because you have so many potential combinations now. Whereas before, as you described, there’s only two items on the menu.

Dr. Lamanna:              

I mean, I’ll let Alessandra speak as well. Obviously, I think there’s no doubt, so just to set the stage, ibrutinib (Imbruvica) is currently approved for everybody with CLL, so whether you’re untreated, retreated, or 17P, the drug that Dr. Keating was just talking about, the VCL-2 inhibitor, venetoclax (Venclexta), is currently approved in patients with relapsed 17-P. 

Dr. Keating:                 

Frontline.

Purva Lad:                   

It’s not approved. I thought it was one prior therapy.

Dr. Lamanna:              

But now, it’s—well, to be fair, this’ll be very soon. So, there’s recent data that is currently at the FDA, right now, it will be approved very soon, probably in anybody who needs retreatment, and there are all these frontline studies running now.

So, when you talk about clinical trials, there’s no doubt that certainly, I think the only thing that I’m concerned about is that for sure, I think that, because of the availability of drugs like ibrutinib, there’s no doubt that those folks are probably getting more avail of these drugs in the community, and so, they may not be seeking a CLL consultation with a specialist, so there’s a little bit of a dampening from the clinical trials on that end, so there is a little bit of a concern. But, in general, there’s—I don’t think, so far, that it’s a huge—there’s certainly, because we’re trying to look at different avenues, about how to look at these oral therapies in combinations, there’s obviously a huge outpouring from patients about wanting to participate in these studies. 

Dr. Ferrajoli:               

No, I totally agree. I mean, it’s never too many. There are so many different aspects that you can use, every patient is gonna have a longer history, where. Then we intervene with another drug, and another drug.

And, we have seen it in other types of cancer, and other types of leukemias, that are different but similar in the same point, there is always gonna be an advantage, or a different aspect, something that the drug is likely doing. It’s worth it to test everything. I don’t—I personally, and I think everyone will agree, we are not done yet.

Dr. Lamanna:              

Yeah, I think the only thing that makes it tricky is, when there are so many things available, then that art of the appropriate, individualizing care can become a little bit more challenging. And, that’s where the expert opinions may be valuable. Because then, the question is, is everybody on the same page, so to speak?

Please remember the opinions expressed on Patient Power are not necessarily the views of our sponsors, contributors, partners or Patient Power. Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.

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