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Highlights From the International Workshop on CLL (iwCLL)

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Published on October 25, 2019

Key Takeaways

  • Novel CLL combination therapies and strategies.   
  • The future of CAR T-cell therapy for CLL.
  • New drug approval underway.

Patient Power host and advocate Carol Preston sits down with leading chronic lymphocytic leukemia (CLL) expert Dr. Philip Thompson to share important takeaways from the International Workshop on CLL (iwCLL) 2019 in Edinburgh, Scotland. Watch as Dr. Thompson discusses novel CLL combination therapies, a new drug approval underway and updates on CAR-T cell therapy. 

To learn more about the meeting visit www.iwcll2019.org

This program is sponsored by CLL Global Research Foundation. This organization has no editorial control. It is produced by Patient Power and Patient Power is solely responsible for program content.

Featuring

I consider myself a pretty well educated CLL patient but there was much presented today that was new to me, and much more that expanded upon what I already knew or filled in missing bits of information.

— CLL Event attendee

Partners

CLL Global Research Foundation

Transcript | Highlights From the International Workshop on CLL (iwCLL)

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.

Carol Preston:            

Dr. Philip Thompson, I wanna ask you having—you were just having return from the big international workshop on CLL in Scotland. What really surprised you? What did you take away? What excited you about what you heard and what you participated in at that meeting? 

Dr. Thompson:           

So, I think the big thing for me was the new combination strategies that we’re seeing for patients with CLL. And by that, I mean combinations of novel targeted agents like ibrutinib (Imbruvica) and venetoclax (Venclexta), but also combinations of novel therapies with traditional treatment like chemoimmunotherapy. We’re seeing extremely high rates of what we call minimal residual disease negative remissions, which means when we look with very sensitive techniques, we can’t find any CLL to the best of our ability. So I think this is super exciting. This gives us the chance of being able to give patients treatment with a limited—of a limited duration, hopefully, therefore, limit side effects.

That was one thing. Another thing that I found really interesting was some of the immune evaluation that’s being done to try and work out how we can make immunotherapy, like CAR-T cells work better for patients with CLL.

Carol Preston:            

Where are we on CAR-T cell? It’s exciting, there have been some successes, some not so successful, it’s a little bit scary. Where do you see CAR-T cell going forward for CLL?

Dr. Thompson:           

So where it is now is probably not quite where I hope it will be. So I think the technology is extremely exciting. I was a fellow when the first case report came out in the New England Journal of Medicine from the University of Pennsylvania. This is back in, I think, 2011. And actually, three of the patients that they reported initially who achieved deep remissions are still in remission. And these were patients who’d failed almost every available treatment.

So I think this gives me the hope that this is a curative treatment for some patients. Now, the operative word being for some patients. And the question is why? So, you know, there are patients like those patients that have complete remission that lasts eight years are probably cured. And then there are patients for whom the treatment doesn’t work at all or it works very transiently.

Carol Preston:            

So is the goal to try to at least find out where patient’s gonna work so you don’t put patients through undue stress and…

Dr. Thompson:           

Yeah, I mean, so—well, the first thing to say about CAR-T is that in general, we’re reserving it mainly for patients where not—traditional options have been exhausted. And by that I also include the novel oral agents that work so well for most patients. So it tends to be—tends to not be a decision that you’re saying oh, we can do CAR-T or we can do ibrutinib. But it’s usually—we need to do CAR-T because your disease isn’t going so well.

So I think maybe in the future when we get them to work better for more patients and maybe we have a better handle on how to manage toxicities, we might see it come earlier in the treatment paradigm because it does have the advantage of being kind of once and done. But so I think there’s a lot of work to be done on making them work for more patients.

Carol Preston:            

Yeah, so going forward, and this is—we really wanna address this to patients. You sound very, very hopeful about what’s coming next. And do I read you correctly on that?

Dr. Thompson:           

Yes, I mean, absolutely. I think even for patients who have been treated before, I think the future is very, very hopeful in the sense that we’re seeing new approvals of new drugs. And probably acalabrutinib (Calquence) is the next drug that’s gonna be approved for CLL. We’re seeing novel combination strategies, we’re seeing new understanding of what makes drugs work in one patient and not in another so that we’re gonna be able to select therapy more individually.

So I think huge amount of hope. In the frontline treatment setting, most patients are now gonna get deep remission with undetectable minimal residual disease, you know, with new combinations and then hopefully have long periods of remission if not cure. So I think very hopeful time, very exciting time to be a CLL researcher.

Carol Preston:            

I did wanna ask you before I let you go, because we talked about this recently, and that is how complex all of these combination therapies have become. Is that daunting to you? Or is that just a wonderful challenge to—a dilemma to…

Dr. Thompson:           

That’s exciting to me.

Carol Preston:            

…to overcome?

Dr. Thompson:           

I mean, it’s wonderful to have all of these options and try—to try and sift through the data to figure out what’s the best in what particular situation. That’s what we as CLL researchers live for.

Carol Preston:            

Well, I love your optimism and I love the hope that you give all of us patients. Thanks, Dr. Thompson. So appreciate it. 

Dr. Thompson:           

You’re welcome. Thank you.

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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