Very interesting interview Brian. Thank you for your persistence in pursuing the 'unwanted effects' that occurred in this trial, and the questionable comparison of Idelalisib with Rituximab. Why are these new drugs not compared to the current gold standard 'FCR'?
Because many of these patients were too fragile for FCR and many more prefer to avoid chemo. Check my earlier posts on this trial with Dr Furman and Dr. Sharman. There is a link to the Furman interview in the latest post.
Still, a better comparison could have been done though it is tricky to think what that might be. In other trials FCR is avoided in the comparison arm because it's hard to beat short term.
Friends, I am new to this website and to you, Dr.Koffman, but so very glad to have found these resources. I am 70 yo guy, have 11p deletion and was treated with FCR 1/12 - 6/12 with very good response and no discernible SE's. I was seen for second opinion before treatment by Mark Lanasa at Duke. He and my treating oncologist agreed and we moved forward. Labs still normal in 2/14. In light of all these new developments, I wonder if you (or anyone who reads this) have thoughts on what questions to ask when I next see my primary and my Duke consultant? Thanks so much for your commitment.
I suspect you mean 11q deletion. Glad you did well with FCR. I would ask for a repeat FISH before you start on any more treatment and I would see what non-chemo choices you might have such as the new oral meds and the new antibodies. That might mean a clinical trial and that would require seeing a CLL expert.
Thanks so much. Correct on the deletion mistake. Guess I need to mind my p's and q's, eh. The Duke clinic I visit annually treats only CLL. They and my treating folks have an formal affiliate relationship. My treating oncologist is fully open to this consultation. I had been following the work in re-engineered t-cells, but was so very happily surprised at Duke last September to learn that ibrutinib was to be imminently approved. I will surely follow your seasoned advice. And I plan to register soon with company making ibrutinib. I will watch your blog with great interest, admiration&good wishes ahead
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