Emerging CLL treatments beyond Imbruvica and Venetoclax. I am not an expert - though. Feel free to copy , edit and repost.

[Hoffy]

Hello,

I am on a trial of Imbruvica and Venetoclax and doing well so far. I am 17P deleted so I am looking at future options- if needed. Fortunately there are a lot of new emerging treatments. I am not an expert - though. Feel free to add on copy , edit and repost!

Below are some of the new CLL treatments I see:

1) MCL1 Inhibitors . It seems like it would work well with Venetoclax and Imbruvica possibly a triple combo. I don't know if this type of trial is coming.

ncbi.nlm.nih.gov/pubmed/268...

AZD5991

cancer.gov/publications/dic...

ME401

2) MicroRNA155 inhibitor. MicroRNA 155 is found in high quantity in aggressive CLL

ncbi.nlm.nih.gov/pubmed/249...

clinicaltrials.gov/ct2/show...

MRG-106 by Miragen

miragen.com/clinical-trials/

3) CAR-T with CD19 as a target

clinicaltrials.gov/ct2/show...

4) CAR-T with ROR1 as a target

ncbi.nlm.nih.gov/pmc/articl...

5) CAR-NK

mdanderson.org/publications...

6) Evaluate CC-122 in Combination With Ibrutinib and Obinutuzumab , CC-122 is next generation Revlimid (lenalidomide)

Be Well!

[Hoffy]

Actually I should say beyond BTK inhibitors and BCL-2 blocker. ACP-196 is coming soon as well as a 2nd gen BTK inhibitor

[Valour in reply to Hoffy]

Holly I am starting the ACP-196 trial you have listed here which consists of Acalabrutinib-Venetoclax and Obinutuzumab infusions. Three meds total but doing Acalabrutinib alone for roughly 30 days then adding the Obinutuzumab infusions along with Acalabrutinib for roughly 30 days and then adding Venetoclax to them on a total trial study of 14 months. The Dr said the dosage levels of Acalabrutinib had to be started low and increased over several weeks before reaching full dosing. It's my understanding that once full doze is achieved they add Obinutuzumab infusions and again they must want to let your body respond or not then based on the test results if your able you then receive the Venetoclax and this becomes the cocktail for the balance of the trial period of 14 months. Bringing three different attack applications to seek kill and disable the cells and pathways. This may not be a good analogy but it's my limited view.

[cartwheels]

Let's hope so I like you have been looking further afield as I too am 17p and on ibrutinib doing very well as it stands venitclax will be my next followed as you have said with new agents and third generation blockers. We still have the option of stem cell graft BMT as well

[Hoffy in reply to cartwheels]

Yes but I see BMT a as the very last resort....

[newyork8]

Great list. What about the ROR1 research with Kipps and the TG Therapeutics ublituximab etc?

[Hoffy]

Yes. I need to add those too!

[Hoffy]

Good point. Let me add on to the list:

Emerging CLL treatments beyond Imbruvica ( BTK Inhibitor ) and Venetoclax ( BCL-2 Blocker) Note: I am not an expert .

Hello,

I am on a trial of Imbruvica and Venetoclax and doing well so far. I am 17P deleted so I am looking at future options- if needed. Fortunately there are a lot of new emerging treatments. I am not an expert - though. Feel free to add on copy , edit and repost!

Below are some of the new CLL treatments I see:

1) MCL1 Inhibitors . It seems like it would work well with Venetoclax and Imbruvica possibly a triple combo. I don't know if this type of trial is coming.

ncbi.nlm.nih.gov/pubmed/268...

AZD5991

cancer.gov/publications/dic...

ME401

2) MicroRNA155 inhibitor. MicroRNA 155 is found in high quantity in aggressive CLL

ncbi.nlm.nih.gov/pubmed/249...

clinicaltrials.gov/ct2/show...

MRG-106 by Miragen

miragen.com/clinical-trials/

3) CAR-T with CD19 as a target

clinicaltrials.gov/ct2/show...

4) CAR-T with ROR1 as a target

ncbi.nlm.nih.gov/pmc/articl...

5) CAR-NK

mdanderson.org/publications...

6) Evaluate CC-122 in Combination With Ibrutinib and Obinutuzumab , CC-122 is next generation Revlimid (lenalidomide)

7) UC-961 (Cirmtuzumab) , ROR1 Antibody

clinicaltrials.gov/ct2/show...

8) Ublituximab CD20 Antibody

clinicaltrials.gov/ct2/show...

9) Bi-clonal Antibodies - Sticks to more than one marker. I have to look up the names.

Be Well!

[DaleFL]

Don’t forget ibrutinib combined with a Heat Shock Protein Inhibitor (SNX-5422). There is a clinical trial going on now. (ID#NCT02973399).

Also, Cart T-Cell Therapy combined with ibrutinib

[Hoffy]

I will add this on! Thanks,

Mark