End of suspense! Here is Dr. Koffman's ASCO 2020 "Top Pick" #1!

[bkoffman]

CLL Society's ASCO 2020 Conference Coverage. End of suspense! Here is Dr. Koffman's ASCO Top Pick #1! Dr. Koffman highlights the CLL 14 Trial, a study looking at fixed-duration venetoclax-obinutuzumab for previously untreated patients with chronic lymphocytic leukemia (CLL). cllsociety.org/2020/08/asco...

[jijic]

Wow, fantastic! Does the paper contain a further breakdown of karyotype and IGVH status (and even age?) in the 47.2% of people who were MRD negative after 18 months?

[bkoffman CLL CURE Hero in reply to jijic]

I believe I attached the link to the abstract that had all the data.

[cajunjeff]

Venetoclax and Gazyva sounds like a great combination therapy. That said, I think this is another example of a pharma company "stacking" the deck in a pharma trial by putting up its drug against another drug it knew going in it would beat - chlorambucil. To my understanding, few doctors in developed countries use chlorambucil anymore to treat cll. It was a foregone conclusion venetoclax would beat chlorambucil.

I think trials that put up venetoclax against FCR or Bendustamisne and Gazyva or ibrutinib and gazyva would be more of a fair fight and yield more valuable information as to our treatment choices. The Flair trail is a good example of a fair fight.

So many cll trials use chlorambucil as the comparator drug. In the last ten years, has chlorambucil won any contest?

Chloroambucil is the Jerry Quarry of Cll drugs. Lol, giving away my age again.

[bkoffman CLL CURE Hero in reply to cajunjeff]

Or they use Arzerra which also loses every fight. It is finally getting better.

[avzuclav in reply to bkoffman]

I think it is only fair to recognize that CLL14 was started in 2014 and was for untreated patients with "coexisting medical conditions" which would've ruled out FCR/BR and preceded first-line ibrutinib approvals.

I appreciated Dr. Sharman's defense of Obin-Clb posted to twitter in July (he was defending ELEVATE-TN and ASCEND).

twitter.com/jeff_sharman/st...

[bkoffman CLL CURE Hero in reply to avzuclav]

All trials begin looking from the present backwards and things are changing so fast in the CLL world.

[Sushibruno in reply to bkoffman]

That's what I like to hear🙂.

[Sushibruno in reply to cajunjeff]

What is Gazyva Jeff?

[bkoffman CLL CURE Hero in reply to Sushibruno]

Obinutuzumab. Gazyva is easier to spell and not mixed up with ofatumumab

[Sushibruno in reply to bkoffman]

Thank you Brian.

[Canuck901]

Excellent news , why can’t this combo

Gazyva and Venetoclax be used as 2nd or 3rd treatment ?

Just asking I’m not an expert .

I remember a few people on here had a small dose of 100mg Venetoclax and Gazyva and reached MRD negative as well not as front line therapy

[bkoffman CLL CURE Hero]

I think it makes great sense. Approval is based on how the drugs were studied, but off label they could be used together. Getting it paid for is another issue.

[Canuck901 in reply to bkoffman]

It makes sense as Rituximab and Venetoclax is approved for 2nd line so I don’t get why the later Gazyva and Venetoclax isn’t yet

[bkoffman CLL CURE Hero]

It's only approved frontline cuz that was who it was tested on. Makes no sense.

[Palmetto in reply to bkoffman]

This is combo husband is getting. Hopefully will be the outcome if he gets through the ramp up alive!!🙏🏻🙏🏻🙏🏻🙏🏻

[Naka]

Wonderful News Dr Koffman!!

Thank you for all your hard work keeping us informed.

[Naka]

Will the Venetoclax dosage make a difference on the outcome? The reason I ask is my dosage was reduced to 200mg for 2 months due to low neutrophils. Back at 300mg and if all good with next week's labs back to 400mg.

[bkoffman CLL CURE Hero]

Most data suggests that a reduced dose works just as well, especially when the tumor bulk has been reduced.