Fine-Tuning the Wave of Innovation in CLL

[SeymourB]

ASH2022 is happening in New Orleans, right now.

Yesterday, there was a great webinar hosted on the PeerView platform that covered Personalized Models for Upfront and Sequential Care With Groundbreaking Treatment, which should be of interest to anyone contemplating firstline or relapsed/refractory treatment.

The slides and replay are now available at:

learn2.peerview.com/1502078...

It was a very concentrated, 2 hour presentation, with many good slides that describe current thinking based on clinical trials.

The presenters represent practices in the UK, Germany, and the U.S. Sometimes what was said in an off-hand comment is as interesting as the details at which they purposely aimed, especially what trials are still needed to prove treatment choices, use of older CIT (chemotherapy), the effect of adding anti-CD20, etc.

=seymour=

[Teegolf47]

One interesting side comment made was that if you relapse because of a mutation on a BTK inhibitor and you are then treated with a BCL2 inhibitor the genetic mutation that appeared while on the BTK inhibitor may go away, which means that you could possibly reuse a covalent BTK inhibitor once again. This has actually happened to me, I relapsed on Ibrutinib with a C481s mutation then moved to Venetoclax and since it appears that I am relapsing on the Ventoclax and the NGS test has shown I no longer have the C481s mutation, I could be retreated with Ibrutinib or move to Zanubrutinib. This doesn’t mean the mutation will not come back, but it just gives me more time before I have to move to a non-covalent BTK or CARt since I am pretty much out of options unless I enter another clinical trial ( it would be my 4th)

Terry

[CLLerinOz Administrator]

I'll second the quality of this webinar. It's excellent.

As you've already noted, it concentrates on both front-line treatment and subsequent therapies for those with relapsed/refractory CLL so people can listen to all of it or just the section that deals with the treatment stage that relates to them. It would be very helpful for anyone trying to decide on a choice of therapy.

While it's geared toward health professionals, a reasonably well-informed patient will gain a lot from it and it's possible to register to view it as a patient. There's a questionnaire to fill out at the start. Just enter n/a or 'I'm not sure' for any questions directed to a health practitioner and enjoy the presentation.

(Seymour, you've saved me from posting about it which I intended to do when I got a chance but the day kept getting away from me. Thanks! 😀)

[bennevisplace]

Thanks for the post, and the link which I've emailed to myself. Prominence in the inbox of a "priveleged" email address is my best shot at remembering to find an hour to view the slides. Otherwise it would just be the latest of many bookmarked links, filed under Medical, read to varying degrees. Time is always tight in December.

[SeymourB in reply to bennevisplace]

Bennevisplace -

Tis the season! So much is coming out of ASH2022, we'll be busy for months catching up.

I would emphasize that these are 4 renowned specialists who provide a couple of graphs (usually PFS and OS, with some AE and MRD) for each trial. All the data has been published previously. This brings it all into a nice summary, and analyzes the possible goals of therapy. Disease eradication seems quite possible for some.

But there's also a subjective side when the studies themselves don't favor any particular option, and it's interesting to hear the comments.

=seymour=

[SeymourB]

In case you want to register to view the replay, they have a survey that uses some abbreviations with which not everyone may be familiar:

TN - treatment naive

FD - fixed duration

liso-cell - a CAR-T therapy

The questions that they ask are not to qualify you to view the replay, but to give them an idea of how knowledgeable doctors and patients might be. I'm not even certain that there are correct answers, given the international audience and what treatments are available in each country.

=seymour=