Three-drug GIV combo promising against high-risk CLL - Patients with deletion 17p or TP53 (from EHA Congress)

[AussieNeil]

For patients with high-risk chronic lymphocytic leukemia (CLL), first-line therapy with a triple combination of targeted agents obinutuzumab (Gazyva), ibrutinib (Imbruvica), and venetoclax (Venclexta) showed encouraging response rates in the phase 2 CLL2-GIVe trial. The complete response rate at final restaging was 58.5%, and 33 patients with a confirmed response were negative for minimal residual disease after a median follow-up of 18.6 months, reported Henriette Huber, MD, of University Hospital Ulm, Germany.

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The overall safety profile of the combination was acceptable, she said, but added that “some higher-grade infections are of concern.” The rate of grade 3 or greater infections/infestations in the study was 19.5%.

Another adverse event of concern is the rate of atrial fibrillation in the comparatively young patient population (median age 62), noted Alexey Danilov, MD, PhD, of City of Hope in Duarte Calif., who commented on the study for MDedge.

He pointed out that second-generation Bruton’s tyrosine kinase (BTK) inhibitors such as acalabrutinib (Calquence) may pose a lower risk of atrial fibrillation than the BTK inhibitor ibrutinib used in the CLL2-GIVe study.

In general, however, the rationale for the combination is sound, Dr. Danilov said.

mdedge.com/hematology-oncol...

This is an unlocked post, so those diagnosed with high risk CLL can find our community: healthunlocked.com/cllsuppo...

Photo: Flowering eucalyptus (gum) tree.

Neil

[Sushibruno]

Ibrutinib is beginning to make me think that it's more common then previously thought in regards to afib and other unwanted And scary side effects. I have a feeling that dr. Lamanna is going to recommend this med for me but I'm heading towards acalabrutinib which I hear has less side effects. What do u think Neil am I overreacting?

[AussieNeil Partner Administrator in reply to Sushibruno]

The CV risk with Ibrutinib increases over time, more so if you have a predisposition to this. Perhaps a combination, time limited treatment may suit you better?

Neil

[Sushibruno in reply to AussieNeil]

Thank you very much Neil... I value your opinion😊. beautiful flower tree.

[charlotte2010dbs]

Hope for people like me :

Complex karyotype (CK) with ≥ 5 unfavorable abnormalities, deletion17p/TP53, IGHV unmutated.

With thanks for this article, Neil

[Jm954 Administrator in reply to charlotte2010dbs]

Crikey, that's a rotton roll of the dice Charlotte. I hope Ibrutinib works well for you

Jackie

.

Crikey, c'est un rotton des dés Charlotte. J'espère que l'ibrutinib fonctionne bien pour vous

Jackie

[charlotte2010dbs in reply to Jm954]

Ibrutinib did not work in my case: clear increase in number, size and metabolism of lymph nodes. Biopsy: suspicion of a ritcher and negative result.

My current treatment is 400 mg venetoclax, and yesterday I received my second infusion of rituximab. We will see if the next review shows improvement. I have great hope and good morale.

Thank you for your attention

.

I really like Crikey

L’ibrutinib n’a pas fonctionné dans mon cas : franche majoration en nombre, en taille et en métabolisme de ganglions. Biopsie : suspicion de ritcher et résultat négatif.

Mon traitement actuel est de 400 mg de venetoclax, et hier j’ai reçu ma seconde perfusion de rituximab. Nous verrons si le prochain examen montre une amélioration.

J’ai grand espoir et un bon moral.

Merci de votre attention.

Crikey