ASH 2015: What Could a Second-Generation BTK Inhibitor Mean for Patients?

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Topics include: Treatment

Patient advocate Carol Preston, on location at the 2015 American Society of Hematology (ASH) conference, discusses the new molecule, ACP-196, a second-generation BTK inhibitor, with CLL expert Dr. Kathryn Kolibaba.  Dr. Kolibaba describes this new molecule’s function including its potential for decreased side effects and her hopes for the future.  “Never,” exclaims Dr. Kolibaba, “have we had a better menu of options.  Never have we had hope like we do now for a cure.”

Sponsored by the Patient Empowerment Network through educational grants from Teva and Pharmacyclics.

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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:

Hello everyone and welcome.  I'm Carol Preston.  I'm reporting from ASH, the American Society of Hematology, the big blood cancer meeting this year in Orlando, Florida.  Lots of exciting and encouraging news for blood cancer patients, certainly in multiple myeloma but also in CLL, chronic lymphocytic leukemia, which is the disease that I've been living with for nine-and-a-half years.  Doctor, would you introduce yourself, a CLL expert?  

Dr. Kolibaba:

Sure.  I'm Dr. Kathryn Kolibaba.  I practice at Compass Oncology in Vancouver, Washington, and we're affiliated with the US Oncology Research. 

Carol Preston:

Tell us about what's exciting you, what's encouraging you for your patients that you're hearing at this meeting and working on. 

Dr. Kolibaba:

Yes.  Well, there are a variety of new molecules.  One of the most exciting ones I believe is ACP?196, which is a second?generation BTK inhibitor.  

Carol Preston:

And what does that mean? 

Dr. Kolibaba:

Right, so CLL cells are abnormal, but they still preserve some of the normal features of a B cell in the body, and part of getting the immune system to respond to a challenge is activating the B?cell receptor.  In a CLL cell, the cell grows, divides and is a cancer using that pathway, so we finally found after all these years molecules that can block the action of that signaling. 

So BTK is one of the enzymes involved in signaling in those abnormal CLL cells, and there are specific drugs, ibrutinib (Imbruvica) is FDA approved, and now there's a second-generation molecule that appears to be more specific just for BTK and not for some of the other enzymes in the body. And we're hopeful that not only will it be more effective but have many fewer side effects.  

Carol Preston:

So correct me or make sure that I'm saying this right.  These inhibitors actually unmask or whisk away the—I call it the Harry Potter invisibility cloak—so that the immune system can go after, can target the…

Dr. Kolibaba:

That's not exactly what these drugs do.  Those would be the checkpoint inhibitors, which are also exciting, and that's on the outside of the cell where we're unhiding the cancer cells from the immune system, and those are also very exciting studies. 

But ACP?196 works on the inside, and so that's where those signaling pathways tell the—work on the DNA side of the cell to make it grow and divide and ignore death signals. 

Carol Preston:

Cancer cells are pretty sneaky, and they manage to work themselves around many a treatment, and we don't know yet about ibrutinib or idelalisib (Zydelig) as to whether there'll be resistance in that area.  

Dr. Kolibaba:

Right. 

Carol Preston:

Is what you're talking about? Is this something that at least in combination can overcome that?  

Dr. Kolibaba:

Well, that drug is not one of those that we think may work if ibrutinib fails, but that has yet to be tested.  But there are drugs presented at this meeting that work on the inside of the CLL signalling pathway at the B?cell receptor and do work when ibrutinib stops.  

Carol Preston:

What is the message that you want to convey to patients?  There were several CLL drugs approved last year. There looks like in 2016 there are going to be approvals, venetoclax and the one that you have talked about, so what is your message?  

Dr. Kolibaba:

My message is we've never had a better menu of options, and even more importantly we've never had hope like we do now for curing this disease with attacking it on the outside and the inside in combination and when other things have failed.  So we're finally getting to a point where we should all be hopeful about CLL.  

Carol Preston:

And maybe a cure?  

Dr. Kolibaba:

Absolutely.  

Carol Preston:

Thank you very much, Dr. Katherine Kolibaba of US Oncology. 

I'm Carol Preston at ASH.  Thanks for watching.  

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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Page last updated on November 18, 2016