Chronic Lymphocytic Leukemia

Matthew S. Davids, MD, sheds light on the significant findings of this study and gave a look ahead to ibrutinib combination therapies in the future treatment landscape of CLL.

Prospects for patients with chronic lymphocytic leukemia have improved with the use of targeted agents such as ibrutinib; however, complete remissions are rare, and treatment options for patients relapsing after treatment with ibrutinib remain limited.

Recent years have seen major advances in diagnostic approaches in CLL, and disease assessment may now include analysis of multiple genetic mutations in addition to recurrent cytogenetic changes. Furthermore, with the development of novel treatment approaches, the significance of prognostic markers is shifting.

Based on supporting data from the phase III DUO trial and the phase II DYNAMO study, duvelisib has been submitted to the FDA for a full approval for the treatment of patients with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma and an accelerated approval for the treatment of patients with relapsed/refractory follicular lymphoma.

Matthew S. Davids, MD, Associate Director, Dana-Farber Cancer Institute Center for Chronic Lymphocytic Leukemia, discusses a multicenter study of ibrutinib (Imbruvica) plus FCR as a frontline therapy for younger patients with chronic lymphocytic leukemia (CLL).&nbsp;<br /> &nbsp;

Matthew S. Davids, MD, MMSc, recently discussed the treatment choices for patients with chronic lymphocytic leukemia, and the factors he considers when choosing a treatment, based on 2 patient cases.

Arsenic trioxide (Trisenox) has been approved by the FDA in&nbsp;combination with the all-trans retinoic acid agent tretinoin for the treatment of adults with newly-diagnosed low-risk acute promyelocytic leukemia with the t(15;17) translocation or <em>PML-RARA</em> gene expression.

The Therapeutic Approach for High-Risk CLL

Clinical Management of Relapsed CLL

The label for nilotinib (Tasigna) has been updated by the FDA with a provision stating patients with Philadelphia chromosome-positive chronic myeloid leukemia in the chronic phase (Ph+ CML-CP) who have received the BCR-ABL tyrosine kinase inhibitor could be eligible to stop treatment after having recieved for at least 3 years and having achieved the specific predetermined criteria.<br /> <br /> &nbsp;

In patients with&nbsp;chronic lymphocytic leukemia (CLL), the addition of ibrutinib to standard frontline chemoimmunotherapy induced negative minimum residual disease (MRD) status in bone marrow for 83% of patients, according to results from a preliminary clinical study presented at the 2017 ASH Annual Meeting.

Ian Flinn, MD, Director of the Blood Cancer Research Program, Sarah Cannon Research Institute, discusses the safety, efficacy, and MRD negativity of a combination of venetoclax (Venclexta) and obinutuzumab (Gazyva) in patients with previously untreated chronic lymphocytic leukemia (CLL) during the 2017 ASH Annual Meeting.<br /> &nbsp;

Adding rituximab (Rituxan) to ibrutinib (Imbruvica) in patients with chronic lymphocytic leukemia (CLL) did not improve progression-free survival (PFS) or overall survival (OS) versus ibrutinib alone, despite there being a faster time to complete remission.

In patients with&nbsp;relapsed/refractory chronic lymphocytic leukemia (CLL), ibrutinib (Imbruvica) in combination with venetoclax (Venclexta) induced an objective response rate (ORR) of 100%, according to findings from the TAP CLARITY clinical trial.&nbsp;

Kerry Rogers, MD, Assistant Professor, Internal Medicine, Division of Hematology, The Ohio State University Comprehensive Cancer Center, discusses a phase II trial of early intervention with ibrutinib (Imbruvica) in patients with asymptomatic, high-risk chronic lymphocytic leukemia (CLL) during the 2017 ASH Annual Meeting.<br /> &nbsp;