Time-to-progression after front-line FCR for CLL: a retrospective, multicohort study

[Jm954]

It has been known for some time that FCR can produce very long remissions (perhaps cures) for some patients with mutated CLL. ncbi.nlm.nih.gov/pmc/articl...

This study looks at unmutated patients and could be an important study for CLL patients or, on the other hand, completely irrelevant as we move into the era of targeted therapies.

FCR is a gold-standard treatment regimen for patients with CLL. However, the question remains of how to treat treatment-naive patients with IGHV-unmutated disease. This retrospective study of patients treated with FCR (at least 3 cycles) between Oct 10, 2000, and Oct 26, 2006 aimed to develop and validate a gene expression signature to identify which of these patients are likely to achieve durable remissions with FCR.

The authors claim to have developed a robust, reproducible 17-gene signature that identifies a subset of treatment-naive patients with IGHV-unmutated CLL who might substantially benefit from treatment with FCR. They recommend testing the value of this gene signature in a prospective study that compares FCR treatment with newer alternative therapies as part of a randomised clinical trial.

thelancet.com/journals/lano...

Unfortunately, at the moment I can't find any more information about this 17 gene signature but hopefully more information will come out and it could form part of the 'test before treat' profile of tests.

Jackie

[cajunjeff]

This is yet another reason why we need to see specialists if possible. Our treatment plans can be so individualized based on things like FISH and mutation status. Now they can look at a grouping of 17 genes to see which unmutated folks do well with FCR? Thats amazing.

I know that Adrian has had an excellent result thus far to FCR and has unmutated cll. Hopefully he can weigh in on this. Who knows, maybe Adrian has the 17 gene signature that might have predicted he would do well.

[AdrianUK]

Interesting data. Jeff is right. I am getting close to two years since starting FCR chemo (next month) and despite being unmutated I am still without any node growth and with a lymphocyte count that hovers around or below 1 (thousand). I got to MRDU status tested following the full six cycle treatment. My immune system remains damaged but as it was pretty damaged before FCR it’s hard to be sure how much of that was caused by treatment and how much by CLL itself and how much did I have a dodgy immune system even before treatment.

[Ghounds in reply to AdrianUK]

I'm idly curious as to whether having an overactive immune system, for example in those affected by multiple allergies, might predispose one to a higher likelihood of blood cancer. I don't anticipate any studies exploring this any time soon though!

[cllady01 Former Volunteer in reply to Ghounds]

Have you seen this? fredhutch.org/en/news/relea...

[Ghounds in reply to cllady01]

I have now! Thank you. I am female with multiple allergies which have increased since I was a teenager.

[Smakwater]

Having CLL is like a closed loop infomercial.

But wait, Theres more!

And, I can't quit watching.

JM