While this peer review may be over technical for many, it does provide an insight into how the new CLL drugs are challenging the established methods of assessing treatment effectiveness.
Panelists:- Myron S. Czuczman, MD, Roswell Park; John C. Byrd, MD, Ohio State;
Richard Furman, MD, Weill Cornell; Thomas J. Kipps, MD, UCSD; Shuo Ma, MD, PhD, Northwestern
The discussion covers:
- Inhibition of Rituximab by Ibrutinib
- ABT-199 (Venetoclax) - ABT-199's remarkable ability to get complete remission with no sign of MRD in bone barrow when used as a single agent and the challenge of avoiding Tumour Lysis Syndrome in use outside of a clinical trial.
- The challenges of Minimal Residual Disease (MRD) negative tests with the new drugs, in particular MRD negative status in blood, vs marrow and contraindications from lymph node sizes
- Assessing the utility of MRD Measures Versus CT Scans.
Note the panel's consensus that CT Scans are overused in CLL.
Photo: An Australian Pipit becoming next to invisible in the stubble