Emerging Approaches to Treating CLL: An Expert’s Perspective

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Topics include: Treatment

What could new and emerging options mean for the future of CLL therapy? Patient advocate Jeff Folloder interviews Dr. John Burke, a CLL expert from Rocky Mountain Cancer Centers to learn Dr. Burke’s perspective on developing research. Dr. Burke discusses current options, potential combination approaches and novel second-generation inhibitors.

This program was made possible by Pharmacyclics LLC and Janssen Biotech, Inc. Produced in partnership with Rocky Mountain Cancer Centers.

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Transcript

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. 

Jeff Folloder:

I'm here with Dr. Burke from Rocky Mountain Cancer Center here in Denver, Colorado.  Tell me about the clinical research that you're doing that you're excited about. 

Dr. Burke:

Yeah, Jeff.  We do a lot of clinical trials in CLL.  I would say some of the highlights would be that we're interested in learning about acalabrutinib, which is a new Bruton tyrosine kinase inhibitor that offers some differences from the existing Bruton kinase tyrosine inhibitor, ibrutinib (Imbruvica), and so we're looking forward to learning more about those results and how acalabrutinib can be used, and does it offer anything better or different than ibrutinib.  So that's one area. 

I think another area of interest that we have is bringing the new monoclonal anti?CD antibody, obinutuzumab (Gazyva), earlier into treatment and incorporating it with other chemotherapeutic drugs besides chlorambucil (Leukeran), where it's currently approved, but perhaps combining that with other chemotherapy drugs in the first?line setting and seeing if that can improve outcomes for patients who might be getting a conventional chemo drug like bendamustine (Treanda). 

We are looking at novel PI3 kinase inhibitors.  Idelalisib (Zydelig) is the one that is currently approved, but there are others, and we're going to learn more about whether these offer any improvement or different side effect profiles. 

And then I think finally incorporation of some of these newer drugs earlier into treatment algorithms is really a key for future research in CLL.  I think we are trying to, you know, even cure some patients in CLL, and the thought is that maybe bringing some of these effective agents earlier, perhaps after chemo or in combination with chemotherapy, may lead to cure in some patients.  So that's what we're hoping for.  

Jeff Folloder:

So a newly diagnosed CLL patient, what kind of quality of life can they expect with some of these new treatments? 

Dr. Burke:

I think it's certainly a different set of risks and benefits compared with sort of more conventional chemo immunotherapies, so the one new treatment that we're using initially in patients with CLL is ibrutinib, and I think it's a different side effect profile.  One, it certainly suppresses the immune system less than conventional chemotherapy, so that's one advantage that it has.  It doesn't cause the degree of fatigue perhaps, nausea that conventional chemotherapy might. 

On the other hand, it has its own set of side effects.  For example, occasional patients have a heart arrhythmia, atrial fibrillation.  Some people have diarrhea from it.  Some people feel achy.  And the other thing you have to take it indefinitely.  So, unlike conventional chemo immunotherapy where you get to take it for six months and stop, we don't really know that you can stop ibrutinib. So once you start it, you're kind of committed to it for a long time.  So there are pros and cons each way. 

Jeff Folloder:

But the future does look bright for CLL patients. 

Dr. Burke:

Absolutely, yes. 

Jeff Folloder:

Thank you very much, Dr. Burke.  

Dr. Burke:

Thanks, Jeff.  

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 June 23, 2017