Duvelisib Dosing Modification Does Not Compromise Efficacy in Heavily Pretreated CLL/SLL

[Jm954]

Reducing or interrupting duvelisib (Copiktra) treatment does not increase toxicity or reduce outcomes with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).

Furthermore, treatment with the PI3K inhibitor led to a superior median progression-free survival (PFS) compared with ofatumumab (Arzerra) while producing rapid and durable responses in heavily pretreated patients.

Results from 2 analyses of the phase III DUO trial presented as posters at the 2019 SOHO Annual Meeting suggest that duvelisib monotherapy is a viable therapy for a patient population that has limited treatment options.

Lots more information here: onclive.com/conference-cove...

Jackie

[PlanetaryKim]

interesting! thanks for sharing.

[HopeME]

There is a Duvelisib/Venetoclax trial going on at Dana Farber for relapsed SLL/CLL. I haven’t heard much about Duvelisib lately. Thoughts on this trial? There is so much research going on it is confusing. I keep hoping that the research efforts lead to a silver bullet. Venetoclax always seems to be in the mix.

Best

Mark

[Jm954 Administrator in reply to HopeME]

Mark, Duvelisib seems more promising than Idelasilib and I’m not aware of any of the severe toxicity’s such as pneumonitis with it that were too common with Idelasilib.

The trial sounds a promising combination.

Jackie

[Justasheet1 in reply to Jm954]

Jackie,

I guess if you failed a BTK it would be good. Combo ‘s seem to look best. But these PI3k’s are third in line following ibrutinib or Acalabrutinib then Venetoclax.

Jeff

[HopeME in reply to Justasheet1]

Hi Jeff: Thanks for your comment. I agree that the medicines you mention are being relied upon more than Duvelisib, which seems to be used as a salvage therapy. That being said, I find it interesting that it is now paired with Venetoclax..

How are you feeling? Is your energy good? I hope you are on the mend.

Best,

Mark

[Justasheet1 in reply to HopeME]

Mark,

I guess if you failed ibrutinib then Venetoclax was going to be next anyhow. Might as well pair it up with Duvelisib and maybe throw in obina.

I’m a little over a month on ibrutinib after getting obina at MDA. I’ve had the roving joint and muscle pain with swelling but it never lasts more than a week for me. All my labs look normal and my energy is back just in time to house train a new puppy. He’s exhausting me but I’m making progress.

I go back to Houston in a year. Thanks for checking. How are you doing?

Jeff

[HopeME in reply to Justasheet1]

Hello Jeff:

It is good to hear things are well with you. Training a puppy is a lot of work but it is also very rewarding. My dog is coming up on 2-years so we are in a good zone. I’m also doing well. I’m still in remission at about 11- months after BR chemo. I go in for a quarterly check up next month. I’m hoping for another couple of years before I need to make any decisions. At present I feel as good as I have in years. No fatigue, etc. I'm thankful I don’t have to make any treatment decisions today. Enjoying every day as if it were my last.

[Justasheet1 in reply to HopeME]

Mark,

Next Thursday would have been 5 years since beginning BR. If you count the 6 months too, I got almost 5 1/2 years remission from BR even being unmutated and 11q-

I wasn’t completely myself for 2 years so the best is yet to come for you.

PS- I need a puppy sitter. Interested? 😆

Jeff

[Jm954 Administrator in reply to Justasheet1]

PS, there is nothing more life enhancing than a new puppy, they are the best kind of exhaustion

Jackie

[Justasheet1 in reply to Jm954]

That’s exactly what the pup told me too. 🐶

[Jm954 Administrator in reply to Justasheet1]

Not necessarily Jeff, if you have certain comorbidities or need anticoagulation then this could move up the ranking but I agree it wouldn't be my first choice until there is more supporting data.

Jackie