Published on September 24, 2015
Are there clinical trials underway that combine powerful emerging CLL treatments? CLL experts from MD Anderson Cancer Center, Dr. Nitin Jain and Dr. Alessandra Ferrajoli, discuss drugs paired in tandem during trials and explore whether combining treatments is more successful than one effective therapy.
Sponsored by the Patient Empowerment Network, which received educational grants from AbbVie and Genentech.
Transcript | Combining New CLL Treatment Options
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From the Internet and from Bob, “Why are we not yet seeing combos of the most effective agents together, such as ABT-199 plus kinase inhibitor plus CD20 MAB?”
Why have targeting combos not yet been trialed? And what can we do to push these trials along much faster?
So this is coming along. I can tell you that there have been—so we have been working on several of the combinations, and other groups have been, too. So it’s just a matter of time. So I think whenever you’ve got a combination, you have to make sure that the single agent activity is there. So we know ibrutinib (Imbruvica), idelalisib (Zydelig) now, they have single agent activity. They are safe. They are FDA approved. You mentioned with the combination with the ABT-199, which is not FDA approved. They’re going in clinical trials. So the combinations are coming.
So I think in the next six months or year, you will see several of these combinations as part of clinical trials available to you. And certainly, a combination of ABT-199 with ibrutinib is something. There’s strong preclinical data we have generated at MD Anderson.
Other groups have also looked at it. So we are actively pursuing those. And I think it’s just a matter of time that we’ll see combinations coming along.
That important question, we also need to consider other components that are not necessarily a mathematical game. Some of these drugs can be good enough just two of them or maybe even one of them. And the other is that you have to keep in mind that this is a disease that lasts for a very, very long time, longer and longer. So you may not want to use all your medications up front together, or you may want to develop other strategies. You may use them sequentially. So it is really quite a complex and rapidly evolving field where we don’t necessarily have to do just what was the chemotherapy approach of the ‘50s or the ‘60s where four is better than three, five is better than four.