Novel Agents for CLL: What Does the Side Effect Profile Look Like?

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Topics include: Treatment

Will side effects from novel agents be less severe? On-site in San Diego at the 2018 American Society of Hematology (ASH) annual meeting, renowned chronic lymphocytic leukemia (CLL) experts Dr. Nitin Jain, from The University of Texas MD Anderson Cancer Center, and Dr. Javier Pinilla-Ibarz, from the H. Lee Moffitt Cancer Center & Research Institute, discuss potential complications and symptoms from second-generation chronic lymphocytic leukemia (CLL) treatments in development. Watch now to learn more.

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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.

Andrew Schorr:                     

So, with ibrutinib (Imbuvica) for sure, and even a drug that we haven’t talked about a lot, idelalisib (Zydelig), of those classes there are coming second-generation, maybe somewhere down in your list there are third generations.

What about the promise of those? Could the side effects be less? Could they be right for other patients? In other words, other generations in these same classes.

Dr. Pinilla:                  

Right. So, certainly, the acalabrutinib (Calquence), which is a second-generation BTK and is currently approved for mantles and lymphoma. So, it is not yet approved for CLL.

Andrew Schorr:          

Yeah, it is approved for…

Dr. Pinilla:                  

…it is for lymphoma. So, it is commercially available, in the US, right now. So, there have been studies running. And there will be a presentation in this meeting, of the 99 frontline patients. They are going to report acalabrutinib single agent. And these are the patients, this is their first line of therapy. And, again, in that abstract, at least it looks like the efficacy is pretty good. Most of the patients receive a partial remission. And the safety profile, I think, that abstract reports expressive risk of atrial fibrillation and almost 60 percent risk of all grade bleeding.

Most of them were like minor bleeding episodes like skin bleeding and ecchymosis and things like that. 

Andrew Schorr:          

What’s that? Define the term.

Dr. Jain:                      

I think that’s like skin bleeding or bruises, easy bruising, things like that. I think there is a randomized study ongoing right now. So, there is a randomized study in relapsed refractory CLL where patients were given ibrutinib versus acalabrutinib. And that randomized study has fully accrued. And we are kind of waiting for the results. 

So, I think that study will really help us, kind of in the same study look at the relative risks or adverse events, in terms of the A-fib, in terms of the bleeding complications, all of the things we kind of think about with ibrutinib to see whether—especially with acalabrutinib, what is the person to show that. So, I think that thing is still unknown. I think it’s generally perceived.

And I guess I just can comment further whether that I think acalabrutinib, at least the patients I have treated in the practice, there is less of a trial GR, practically no arthralgias. So, some of the symptoms, which you have with long-term ibrutinib, are less common with the acalabrutinib.

Dr. Pinilla:              

It is truly a perception that all of us who treat CLL, and we have experience with acalabrutinib have. However, as he mentioned very well, we need to really wait for the data from the randomized trial who really, really, in a very good way, compared both drugs. But definitely perception about chronic side effects is positive.

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 February 28, 2019