ASH 2018: Dr. Chadi Nabhan on the Cost of Ibrutinib vs. Chemo vs Chemoimmunotherapy in CLL and on way too much chemo being used.

[bkoffman]

Hi,

If you have been on our website recently you have already met Dr. Nabhan talking about patient reported outcomes. This time at ASH 2018, we also discussed his innovative research using claims data from 2014- 2017 on the total cost of care for CLL patients who took ibrutinib versus chemotherapy or chemo-immunotherapy (CT/CIT).

Guess what- The total cost is cheaper with ibrutinib.

But here is the really scary and depressing part.

1,464 patients received chemotherapy alone. This is a huge concern as there is no role for chemotherapy on its own in CLL. In fact, there is very little role for chemo-immunotherapy.

The trial was designed to look at the economic impact of drug choice, but to his credit Dr. Nabhan highlights his finding about the lousy treatment too many patients are still getting.

Here is the link my ASH 2018 interview: cllsociety.org/2019/08/ash-...

I have more coming from Dr. Nabhan from ASH soon. I like doing stuff that isn’t just the science research but the real world data

Stay strong.

We are all in this together.

Brian

Brian Koffman MDCM DCFP, DABFM, MS Ed

Co-Founder, Executive VP and Chief Medical Officer

CLL Society, Inc

cllsociety.org

[sbkris1]

Thank you for sharing this important info!

[Benlewis]

Thanks Brian, interesting but I’m puzzled by your statement that there is no role for chemotherapy on its own in CLL. FCR is chemotherapy and still considered the “gold standard” by many CLL doctors for mutated younger patients. Am I misinterpreting something here?

[PlanetaryKim in reply to Benlewis]

FCR is chemo-immunotherapy, not chemo alone. The "R" is the immunotherapy.

[Benlewis in reply to PlanetaryKim]

Thanks Kim

[PlanetaryKim in reply to Benlewis]

Any drug ending in "mab" (for monoclonal antibody) is immunotherapy, such as rituximab, obinutuzumab, or for solid tumor cancers: pembrolizumab, nivolumab, etc.

[Benlewis in reply to PlanetaryKim]

I still learn a lot from this site, thanks again

[bkoffman CLL CURE Hero in reply to Benlewis]

FCR is chemo-immunotherapy. F or FC would be chemo and should never be used.

[JigFettler Volunteer in reply to bkoffman]

I am not clear about what you are saying...

FCR should not be used.

Or F and FC alone should not be used?

Jig

[bkoffman CLL CURE Hero in reply to JigFettler]

F or FC or chlorambucil or B shouldn't be used without a monoclonal antibody.

[Big_Dee in reply to bkoffman]

Hi Brian

I am glad you clarified that.

[PlanetaryKim]

Good work Brian! Thank you for sharing.

[Smakwater]

The matrice is too often viewed as one dimensional. This is another good reason to become a knowledgable self advocate.

Good point,

JM