CLL Research: Phase 2 CAPTIVATE Study Suggests... - CLL Support

CLL Support

23,336 members40,042 posts

CLL Research: Phase 2 CAPTIVATE Study Suggests Role for Fixed-Duration Treatment of CLL/SLL

WinJ3 profile image
6 Replies

cllpharmacist.com/cll-resea...

The data in the uMRD cohort of this trial suggest that fixed-duration therapy is feasible in patients who achieve undetectable MRD (uMRD) status. The selection of durations for these clinical trials can be arbitrary. Investigators hope that the follow up of patients who did not achieve uMRD within the initial fifteen months may show that longer “MRD-guided” courses of treatment can result in a better understanding of what is the optimal treatment duration with combination therapy of ibrutinib plus venetoclax. Investigators hope to publish this data at future conferences.

There are several reasons to look for fixed-duration treatments. Providers like fixed durations because they limit exposure to drugs which can impact side effects or toxicities. Further, investigators theorize that if you are not on continuous treatment, you reduce the chance of resistance developing to a drug and increase the potential to re-treat using this same agent. (See article in Recent Articles Section of our website that features an article by Dr. Meghan Thompson on successful retreatment with venetoclax.)

The question remains as to the advisability of stopping all therapy upon attainment of uMRD. This study begins to answer this question with 1-year DFS data that indicates little difference in outcomes for those who continue on ibrutinib versus those who stopped treatment because they received placebo. I personally am affected by this research as I was able to attain uMRD seven months after adding venetoclax to the ibrutinib I had taken for more than three years. My specialist and I agreed that there is still not enough long-term data for a high risk patient such as me to cease some form of therapy. It will be interesting to see data after longer follow-up in this clinical trial.

This is exciting early data that hopefully bring us closer to determining the efficacy of fixed-duration treatments in attaining uMRD and hopefully be able to withhold treatment for a significant period of time without relapse. There are many studies of different combinations being conducted world-wide to attempt to find the best combination of drugs with the lowest side effect profiles. In the past, the only fixed-duration treatments were chemoimmunotherapy which can have long-term toxic effects on our bodies, and raise our risk of infection and secondary cancers above levels associated with the disease itself.

Written by
WinJ3 profile image
WinJ3
To view profiles and participate in discussions please or .
Read more about...
6 Replies
LeoPa profile image
LeoPa

I like the idea of fixed duration. But I+V? Sounds like 300K annually even in the EU. 😕

Big_Dee profile image
Big_Dee

Hello WinJ3

We have been waiting for the outcome of these trials, looks like they are starting to draw some conclusions, great.

WinJ3 profile image
WinJ3 in reply toBig_Dee

Yes, I like seeing progress like this.

Hoffy profile image
Hoffy

I am on this trial and it has been great. I have been UMRD for over 2.5 years,

Hoffy

bbreeland profile image
bbreeland in reply toHoffy

Wonderful news Hoffy- so you are not on a treatment break after reaching MRD undetectable?

Hoffy profile image
Hoffy in reply tobbreeland

I am on pretty much a break. I am on either Imbruvica or a placebo. I know it is a placebo since the side effects went away.....

I feel very fortunate.

Be well,

Hoffy

Not what you're looking for?

You may also like...

Dr. Shadman on Fixed Durations of Treatment in CLL

Mazyar Shadman, MD, MPH Published: Monday, Jul 08, 2019 Mazyar Shadman, MD, MPH, assistant member,...
Jm954 profile image
Administrator

Dr. John Allan - Chronic Lymphocytic Leukemia (CLL) Patients @Undetectable Measurable Residual Disease (MRD) after Ibrutinib Plus Venetoclax

ASH 2022: Dr. John Allan on Outcomes for Chronic Lymphocytic Leukemia (CLL) Patients with...
lankisterguy profile image
Volunteer

Outcomes after UMRD with 1st line Ib +Ven Fixed Duration Treatment Versus Continued Ibr Follow-up in the CAPTIVATE Study

First-line Ibr + Ven is an all-oral, once-daily, chemotherapy-free regimen that continues to...
Jm954 profile image
Administrator

Optimal Treatment Combinations in the Management of CLL/SLL Jeff Sharman, MD Provided by Clinical Care Options, LLC

Optimal Treatment Combinations in the Management of CLL/SLL Jeff Sharman, MD An installment...
lankisterguy profile image
Volunteer

Chronic Lymphocytic Leukemia Therapy Guided by Measurable Residual Disease

From the New England Journal of Medicine 10th December 2023 "The CLL treatment landscape has...
Jm954 profile image
Administrator