Triplet Regimen Shows Promise in CLL -Zanubrutinib, obinutuzumab, & venetoclax combo achieves rapid undetectable MRD -MedPageToday -07/07/20

[cujoe]

Treatment triple-header news from the MedPage Today. From the article:

At the American Society of Clinical Oncology virtual meeting, initial findings from a phase II study were reported on minimum residual disease (MRD)-driven, time-limited therapy with a regimen known as BOVen (zanubrutinib, obinutuzumab, and venetoclax) in previously untreated patients with chronic lymphocytic leukemia (CLL).

In this exclusive MedPage Today video, study author Jacob Soumerai, MD, of Massachusetts General Hospital Cancer Center in Boston, explains the study results and implications.

At the time of posting, the video with Dr. Soumerai in the link below was not working. (A written transcript is provided) If the video link has not been corrected, I have provided a second link that will take you directly to the video.

medpagetoday.com/meetingcov...

Direct link to the interview video

assets14.ign.com/videos/zen...

Treatment Options keep expanding. Be Safe/Stay Well - cujoe

[MaxSmart]

Thanks for posting Joe. I am on zanubrutinib now. WBC down from 150-20. Hoping to add Venetoclax soon for limited duration therapy. And then get off these pills and try to feel normal again.

Being diagnosed with cancer was a real shock to my system and taking these pills has caused me to gain weight even though I’m on exactly the same diet as before.

[cujoe in reply to MaxSmart]

Max, Always good to see and hear of people doing well on the wide range of treatments now available. I am one of the truly fortunate ones who is 14 years out on W&W and with stable disease. I am hypogammaglobulinemic, but have yet to have any problems with infections, etc. However, that status has made me extra careful about distancing and hand washing even before COVID-19 hit the HC scene. In fact, since I consistently feel fine and my palpable nodes have now all dissipated, if not for the initial diagnosis and semi-annual HO visits, I would not even know I had CLL.

The treatment options are light-years ahead of what was available 14 years ago. CHOP was the first-line treatment and rituximab was the new kid on the block, leading to R-CHOP. BTK inhibitors truly changed the world for most CLL patients and it seems the new treatment top-hits just keep on coming. One of the hopes for these new drug combinations is that patients can relatively quickly get off them completely and get back to feeling "normal" again.

Weight gain is a real challenge for most people, it seems, regardless of health status. I made radical changes to my diet and lifestyle after I was diagnosed with CLL and upped the ante significantly when cancer #2, prostate cancer, came along about 5 years later. I'm currently beating the odds on both cancers and have been inexplicably off treatment for PCa for 30+ months with descending PSA labs. Has my diet and the many supplements I take played a role in that outcome or my stable CLL. Well, no way to know. You will quickly find here on this forum there is a strong bias against the effectiveness of diet and supplements as adjuvants to SOC. Since I am not on treatment and maintain consistently good labs and general health, I will continue with my program until change is warranted. Everyone needs to do their own research and come to their own conclusions. There is a lot of junk "science" out there to support any and all things related to your health. It's a maze of contradicting "facts", but there is a way. I'm a believer in the Information>Understanding>Knowledge>Truth pathway. Verify the Information and you have the foundation for Understanding that might lead to a small kernel of Knowledge and, if you are really fortunate, a tiny glimpse of an ultimate Truth.

Best wishes to you for continued good health outcomes with CLL and Stay Positive.

Be Safe/Stay Well - cujoe

[MaxSmart in reply to cujoe]

That’s great to hear. Congratulations. Are you 13 Q?

[cujoe in reply to MaxSmart]

Thanks. 13Q double-deletion and mutated IgVH. A very good place to start and hopefully a good one for the future.

[Sushibruno in reply to cujoe]

Hi can I ask what supplements and diet are you on cujoe?

[cujoe in reply to Sushibruno]

WF-PB diet started about 8 years back, progressively more so every year. I would never go back now just based on ethical reasons. As for supplements, I never give specific recommendations. That said, i have come to believe that most cancers develop and progress in response to inflammation, glycolysis, cholesterol, and in some specific cases hormone imbalance, so it is pretty easy to find diets and supplements that will act to reduce each of those. And while neither may be curative, done with good knowledge and tailored to your individual metabolism, it will at a minimum, likely improve your overall health. Add in a stress-free work/home environment and regular exercise and sleep and you are looking at a good foundation to deal with any health issue. Good Luck and Good Health to you. cujoe

[Sushibruno in reply to cujoe]

Thank you for responding, but what is WF-PB?

[mrsjsmith in reply to Sushibruno]

Whole foods, plant based.

[Canuck901 in reply to Sushibruno]

Plant based and spray free if possible and whole foods not processed

[cujoe in reply to Sushibruno]

Already two winners and one close second.

[Ghounds in reply to cujoe]

PB? Assuming WF is wheat free?

[Sushibruno]

This is all I have to say 😊😊😊😊👌👌👌👌👌👍👍👍👍👍😊😊😊😊😊😊.

[Hidden]

venetoclax still seems to be the heavy lifter. similiar results using other btk and gazyva/rituxan

[cujoe in reply to Hidden]

Seems that is often the case with drug combos.

[SBMACLL]

I am on the ZVO study. Seven months +/- to UMRD. Zero bothersome side effects. Much better than I thought it would be. Biggest side effect was what I learned about myself after being in an infusion clinic all day, witnessing the other patients, what they were going through and the incredible staff. I am in amazement of both. As stupid as it sounds, I am a better person for doing this study.

[SBMACLL]

Should have stated that I have been on the ZVO study for 12 months.

[bennevisplace]

Hit the B's from all directions - way to go!

What surprises me is that the ZVO triplet seems easier to tolerate, with half the rate of grade 3/4 neutropenia compared with V+BTK inhibitor (probably Ibrutinib?).