2nd CLL treatment

[Champlain]

Has anyone received the combine treatments Acala & Brutunib?

or a combine treatments: Retinuzomab & Venetoclax?

I am in Ontario Canada

[lankisterguy Volunteer]

Hi Champlain,

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I see you joined us 6 years ago and have been on treatment in the past. I'm not certain if that treatment was a chemotherapy like BR* or FCR**, or if you were treated with Ibrutinib / Imbruvica.

*BR= chemoexperts.com/bendamusti...

**FCR= cancerresearchuk.org/about-...

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I believe you are now asking about Acalabrutinib / Calquence or a combination treatment of Obinutuzumab / Gazyva combined with Venetoclax / Venclexta

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We had numerous discussions in the past - the most recent one yesterday:

healthunlocked.com/cllsuppo...

I don't want to overwhelm you with too much information, but you picked 2 of our most common topics here.

We have 5,883 previous discussions on Venetoclax and Obinutuzumab you can see the list here with the most pertinent and recent on the first page:

healthunlocked.com/cllsuppo...

And the other for Acalabrutinib / Calquence has 992 past postings:

healthunlocked.com/cllsuppo...

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Len

[DanBro1 in reply to lankisterguy]

Very thorough reply, Len! I am an Obinutuzumab/Venclexta veteran, myself.

[Champlain]

My first round of treatment four years ago combination of obinutuzumab and clorembucil for six months. My second round coming soon, my oncologist is suggesting retinuzomad and venetoclax. This is to treat CD20, does anyone experience those medication and those it seems to be a good combination. I do appreciate the Health Unlocked web site.

[lankisterguy Volunteer in reply to Champlain]

Hi Champlain,

The most often used combination therapies are either Rituximab (Rituxan) & Venetoclax or Obinutuzumab & Venetoclax. I provided the link for O &V above. And here are the previous posts for R & V : healthunlocked.com/cllsuppo...

Len

[CLLerinOz Administrator in reply to Champlain]

Hi Champlain

Thanks for the details about your previous treatment. To add that information to your profile, you can edit it here: healthunlocked.com/profile/...

Choosing your second CLL therapy can be impacted by the sort of treatment you've had for your first therapy and by the results of tests you should have done before every treatment decision is made.

Ideally, before starting any subsequent CLL treatment, you should be re-tested with a FISH test and have your TP53 status tested. If you've not already been tested for IGHV, that should be done, too. I'm not sure how easy those tests are to access in Ontario.

Those results and your medical history - how fit you are, whether you have a history of high blood pressure, what your kidney health is like - can be used to determine which treatment would be more suitable for you.

If you choose to take the BTK inhibitor treatment option, you'll need to take either ibrutinib or acalabrutinib (not both combined) and it would be a continuous treatment, taken every day.

While the venetoclax + rituximab option has the benefit of being a time-limited (ie not a continuous) therapy like either ibrutinib or acalabrutinib, the addition of rituximab has the downside of requiring hospital visits which might also be needed for the ramp-up period for venetoclax, depending on your risk of tumor lysis syndrome.

You can also find a list of clinical trials that are currently recruiting patients in Canada here: clinicaltrials.gov/ct2/resu... (note: some in the list are for untreated patients so you'd not be eligible for them)

Don't hesitate to ask any other questions that you have about your upcoming treatment but understand that CLL Canada cllcanada.org/ may be your best resource for information specific to Canada and Ontario in particular.

[Champlain in reply to CLLerinOz]

Thank you so much CLLerinOz, great information which confirms my choice. Great questions to ask my oncologist on Thursday December 22nd. I keep active even with the CLL symptoms that have increased in the last few months, I have a positive attitude.

[CLLerinOz Administrator in reply to Champlain]

All the best for the 22nd 😀

[Fastbike14]

Hi Champlain, firstly good luck with your new treatment. I've been started on Venetoclax and Rituximab. Venetoclax required 2 days in hospital to start the ramp up and all other increases were done as an outpatient returning for bloods at 6hrs and 24 hrs. This all went well with no side effects. Rituximab is a monthly infusion, first one gave me the shivers a headache and 18 days of diarrhoea. All other infusions have been easy and I can honestly say I feel so much better than when I was in Ibrutinib.

Hope you get on well with your treatment and all the best for Christmas and new year