Chronic Lymphocytic Leukemia

According to a retrospective phase I/II study, over 80% of patients with relapsed or refractory chronic lymphocytic leukemia responded to concurrent treatment with ibrutinib and the CD19-targeted chimeric antigen receptor CAR T-cell therapy, JCAR014.¹ Findings from this study were presented at the 60th American Society of Hematology Annual Meeting.

According to updated data from the phase II ELIANA study, CD19-targeted CAR T-cell therapy tisagenlecleucel as treatment of pediatric and young adult patients with relapsed or refractory acute lymphoblastic leukemia sustained rates of relapse-free survival and overall survival at 24 and 18 months. 

Progression-free survival was significantly improved with both ibrutinib as monotherapy and in combination with rituximab when compared to bendamustine plus rituximab as a treatment for older patients with newly diagnosed chronic lymphocytic leukemia. These data were presented at the 2018 ASH Annual Meeting.

Susan M. O’Brien, MD, discusses the challenges with the 3 oral agents approved in chronic lymphocytic leukemia.

CLL is a malignant disease characterized by progressive accumulation of immature, immunophenotypically distinct lymphocytes in the blood, bone marrow, and lymphatic tissues. Although the clinical course of CLL can be unpredictable, this disease is typically slow-progressing and occurs most often in patients ≥65 years of age. As such, treatment, if indicated, is typically conservative. Current CLL treatments are not considered to be curative; however, long-term remission can be achieved in some patients using allogenic stem cell transplantation.

Chronic lymphocytic leukemia is characterized by the clonal proliferation and accumulation of small, mature-appearing CD5-positive B lymphocytes in the blood, bone marrow, and secondary lymphoid tissues. A CLL diagnosis is established by the presence of more than 5x109/L peripheral lymphocytes co-expressing CD5, CD19, and CD23, and weakly expressing CD20, CD79b, and surface immunoglobulin. Small lymphocytic lymphoma represents a clinical variant of CLL and is similarly managed.

Richard Furman, MD, discusses how survival times for patients with chronic lymphocytic leukemia have increased dramatically in the past decade, thanks to an ever-expanding armamentarium of novel agents and more patients now being diagnosed earlier.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;October 2018, including several new FDA approvals, priority reviews, a breakthrough therapy designation, and more, in a variety of cancer types.<br /> &nbsp;

Treatment-na&iuml;ve patients with chronic lymphocytic leukemia who had comorbidities saw a reduction in the risk of disease progression or death after treatment with venetoclax combined with obinutuzumab versus obinutuzumab plus chlorambucil.

Sarah K. Tasian, MD, discusses what she finds most interesting about Philadelphia chromosome (Ph-like) acute lymphoblastic leukemia.

A&nbsp;supplemental new drug application for ibrutinib (Imbruvica) has been granted a priority review by the FDA&nbsp;for use in combination with obinutuzumab (Gazyva) as a frontline treatment for adult patients with chronic lymphocytic leukemia or small lymphocytic lymphoma.

Danielle Brander, MD,&nbsp;discusses the current treatment landscape in the frontline setting for patients with chronic lymphocytic leukemia.

Shagun Arora, MD, discusses new agents and combination studies beyond chemoimmunotherapy for patients with CLL.

Mazyar Shadman, MD,&nbsp;discusses the evolution of therapy in CLL and how physicians are working to balance these novel agents with additional modalities.<br /> &nbsp;

Infographic: Here, we share the top 5 oncology news stories we reported this week, including the most recent FDA updates and expert insights on key developments in the field.

A look back at all the&nbsp;FDA news&nbsp;that happened in the month of&nbsp;September 2018, including several new approvals, priority reviews, a breakthrough therapy designation, and more, in a variety of cancer types.

Javier A. Pinilla-Ibarz, MD, PhD,&nbsp;discusses updates in the treatment of patients with chronic lymphocytic leukemia.

In an interview with&nbsp;<em>Targeted Oncology</em>, Katy Rezvani, MD, discussed the potential she sees with CAR NK cells. She also highlighted some of the challenges with both CAR T-cell therapy in patients with CLL, as well as challenges to overcome with CAR NK cells in this patient population.

Duvelisib (Copiktra) has been approved by the FDA for the&nbsp;treatment of patients with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma or relapsed/refractory follicular lymphoma.&nbsp;Both indications are for the treatment of patients who have received at least 2 prior therapies.

Based on data from the phase III MURANO trial, the European Medicines Agency&rsquo;s Committee for Medicinal Products for Human Use has recommended the approval of venetoclax&nbsp;for patients with chronic lymphocytic leukemia who have received at least 1 previous therapy. AbbVie, a co-developer of venetoclax with Roche, announced the CHMP&rsquo;s decision in a news release.

Javier Pinilla-Ibarz, MD, PhD, senior member of the Department of Malignant Hematology at Moffitt Cancer Center, discusses the current treatment landscape of chronic lymphocytic leukemia.

Minimal residual disease data from the phase III MURANO trial has been added to the label for venetoclax (Venclexta) by the FDA for its&nbsp;approved use in combination with rituximab (Rituxan) for previously-treated patients with chronic lymphocytic leukemia.

Javier Pinilla-Ibarz, MD, PhD, senior member of the Department of Malignant Hematology at Moffitt Cancer Center, discusses the biggest challenge in treating patients with chronic lymphocytic leukemia.

Kerry Rogers, MD, assistant professor at The Ohio State University Comprehensive Cancer Center, discusses a short-term&nbsp;treatment&nbsp;strategy for&nbsp;reducing tumor burden and the risk for tumor lysis syndrome in patients with&nbsp;chronic lymphocytic leukemia.

Susan M. O&rsquo;Brien, MD,&nbsp;discusses some of the latest intriguing data in the treatment of CLL, and the growing importance of mutation status.