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Innovative Treatment Strategies for CLL: How Can Patients Become MRD Negative?

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Published on April 9, 2018

How important is it for chronic lymphocytic leukemia (CLL) patients to reach minimal residual disease (MRD) negative status? What is the treatment plan for patients with unique CLL conditions? CLL expert Dr. Nicole Lamanna from Columbia University Medical Centershares the different approaches to therapy with novel agents used for frontline treatment, patients with genetic mutations, and regimens used for those who are unresponsive to frontline. Dr. Lamanna also discusses the possibility of a curative strategy upon reaching MRD-negative status. Watch now to find out more about the treatment avenues that can lead to MRD negative status.


Transcript | Innovative Treatment Strategies for CLL: How Can Patients Become MRD Negative?

But in the frontline therapy there were several presentations… 

So I think one of the things that we're looking to do is if—whether that be, and how we get there is obviously—it was like alphabet soup during the meeting, there were multiple different regimens, and certainly that we don't have the answer to yet, but if you can achieve that then there might be ways to truncate the oral therapies so that you're not on indefinite therapy.  That was one strategy that we are all looking at. 

Another strategy would be can you truncate how much chemoimmunotherapy if you're going to use any chemoimmunotherapy in the frontline.  And certainly for favorable patients, so the MD Anderson data was looking at whether or not for favorable subgroups doing something like that would lead maybe even perhaps to a curative strategy.  I use the word "cure," but looking at that data that they did many, many years ago at the mutated favorable folks, 13q deletion, can you enhance that by adding some of the orals and truncate chemoimmunotherapy with fludarabine (Fludara) and cyclophosphamide (Cytoxan) or obinutuzumab (Gazyva), a couple of cycles, then looking at MRD and getting those patients really to a cure.  So MRD was a very hot topic for ASH this year.  

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