In this short video taken at iwCLL Collogne Germany, Andrew Schorr interviews Dr Hillmen:
"As a full slate of new treatments for CLL show promise, one approach--with a drug called idelalisib--is to inhibit the PI3k pathway that is active in CLL. Dr. Peter Hillmen explains how this drug works and where it could fit in as part of non-chemo CLL therapy."
Interesting to hear that in contrast to the Patient Power introduction, in the UK, Dr Hillmen sees Idelalisib as likely to have a place with a chemotherapy backbone of Chlorambucil + Ofatumumab or Bendamustine + Ofatumumab.
Neil
The willie wagtail is a common Australian native fantail that I've found very hard to capture due to their unceasing activity. Named for the way they wag their fantail around, these birds were disliked by Indigenous people in some areas, as they were thought to loiter at the edge of camps, listening to conversations then telling the secrets elsewhere.
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AussieNeil
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I was fortunate to meet Prof Peter Hillmen after a meeting in London when he explained to me that the challenge in treating CLL is to find a treatment that the disease cannot overcome eventually. As an ex geneticist he explained that as you add agents to a treatment the odds of the disease managing to mutate around it reduce dramatically and an ideal combination of three may prevent this entirely..I guess this explains some of the thinking behind alphabet soup combinations.
It is really exciting to know that Idelalisib is achieving such good early results we all remember the excitement when it arrived on the scene as CAL101 and then GS1101 I wish they would stop changing the names so quickly.
I recall the early discussions and excitement as the kinase inhibitors arrived on the trial scene together. I think we are going to hear a lot more about Idelalisib soon - There are ten study papers in at ASH this year i believe.
Ibrutinib has been hogging the limelight and seems to be the poster boy at the moment, When they both arrived on the scene their novel treatment strategies were discussed together in patient community conversation. I believe Ibrutinib is also in trials with chemotheraputics.
As a layman I understand the strategy to trial with Chemotheraputics; perhaps this will provide a lasting remission? maybe cut down on the long term treatment cost? By preventing bthe need to remain on an expensive pill to keep the disease at bay. It will be interesting to review the trial data as it comes available,
In the future we will see other combinations of Idelalisib + novel non chemo agents too as they filter through the trials system. there is a raft of them coming.
Listening to the Idelalisib drug developers their long term objective is to find a combination that has the least toxic footprint and provide a lasting remission. Everyone is concerned about the price of the novel small molecules but if a way to use them that provides a lasting remission is found that worry could become history. So there will be many more trialed combinations and opportunities for UK patients to access trials in the future ahead of approvals.
What I find really interesting about Gilead Sciences the organisation behind Idelalisib is their background working with the HIV and Hepatitis C populations they bring with them some interesting approaches that may help us tackle the unmet needs of CLL patients..
This man is amazing! I am fortunate in having him as my consultant and he is so knowledgeable yet very human and talks to me in a way he gives me such hope.I am so lucky to have found him. Whatever my outcome he has given me the belief I can conquer this disease. Going on the CLEAR trial soon and believe he is the best chance I have .
Idelalisib Combo Rings Bells in Relapsed CLL:- Medscape Hematology video/transcript of Bruce Cheson MD, from Georgetown University Hospital, Lombardi Comprehensive Cancer Center:
The results were rather interesting. The median progression-free survival was 5.5 months for the placebo group vs not yet reached for the idelalisib group; the trial was stopped early because of overwhelming efficacy. There were improved rates of overall response: 81% in the idelalisib group vs 13% in the placebo group, and progression-free survival was significantly longer with idelalisib. But most notable was that the group receiving idelalisib saw an improvement in overall survival at the P = .02 level of significance. It is uncommon in studies of patients with CLL that anything really prolongs survival."
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Dr. Shadman on Fixed Durations of Treatment in CLL
unmutated cll patient treatment with fcr 
