Dr. Brian Koffman reports on the 6 CLL-focused... - CLL Support

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Dr. Brian Koffman reports on the 6 CLL-focused oral presentations from Day 1.

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bkoffmanCLL CURE Hero
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Highlights from the First Day of ASH 2021! Dr. Brian Koffman reports on the 6 CLL-focused oral presentations from Day 1. Learn more about the increasing importance of limited duration therapies using combinations of drugs that have complementary, non-overlapping mechanisms mechanisms of action, the trend towards MRD guided therapy, the growing use of next generation sequencing (NGS) as the preferred measure of MRD... and much more! cllsociety.org/2021/12/ash-...

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bkoffman
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HopeME profile image
HopeME

Thank you for your summary. Question: In the case of those patients who had CIT frontline and received a good response but not UMRD is the thought now beginning to lean toward immediately entering a second line treatment? Did I read that correctly? Or is this only applicable for CIT patients frontline who did achieve UMRD and then fell out of this status? Although it would seem the two aforementioned categories should be treated in the same fashion.

Best

Mark

Mystic75 profile image
Mystic75

Thank you, Dr. Koffman!

dave52411 profile image
dave52411

Hello. Can you clarify the statement: "This trial also hints a possible emerging new trend: Treat when the disease becomes MRD+, instead of waiting until it clinically progresses and meets the usual criteria for treatment." Does this mean treating CLL earlier rather than W&W until symptoms are significant ?

JigFettler profile image
JigFettlerVolunteer in reply todave52411

In Feb 2018 when I saw the great Prof Hillmen, Leeds, UK... he was saying that treatment start would lean towards an earlier time.

Was he also telling me I had left my treatment start late!

Maybe less disease to treat means less drug for less time etc

Jig

dave52411 profile image
dave52411 in reply toJigFettler

Thanks ! Maybe early treatment results in less disease to treat requiring less drugs for less time ? Interesting...

JigFettler profile image
JigFettlerVolunteer in reply todave52411

Seems logical to me... this principle would apply to many disease processes, and all other non Haem malignancy.

Who will break the habit and go earlier? We need early treatment starts with new agents. Gets complicated, especially if postulating lower doses too.

But I see an issue... lower doses for less time = less profit for big Pharma...

Jig

Teddo profile image
Teddo in reply todave52411

Dave

I think DrK. is discussing resuming tx after someone is relapsing. Start tx sooner rather than wait for more of a decline when someone goes from MRD neg to MRD positive. His comment came after discussing a trial for relapsed pts.

bkoffman profile image
bkoffmanCLL CURE Hero in reply toTeddo

Not less drug but fewer cancer cells to mutate and become harder to treat or transform. Just theoretical now

maggiesgrandmom profile image
maggiesgrandmom

Thanks for all of this Dr. Koffman! Are you thinking it is best to stop venetoclax when you reach umrd rather than continuing on indefinitely? Does continuing on indefinitely cause a risk that the Venetoclax may stop working? Either way it is certainly positive that you could re start V if it comes back after you took a pause.

JigFettler profile image
JigFettlerVolunteer

Thank you Brian. I appreciate the intense stint of focused and hard work to produce your summary.

We are all indebted to you.

Regards

Jig

bennevisplace profile image
bennevisplace

Beautifully summarised, thank you.

BobbyFour profile image
BobbyFour

Thanks for the great summary. It certainly feels like we are on the cusp of significant progress.

Peggy4 profile image
Peggy4

Thank you.Peggy

New-bee-cell profile image
New-bee-cell

Thank you very much. Your daily summaries of the ASH conference are much appreciated 👍

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