ASH 2023

[MovingForward4423]

patientpower.info/chronic-l...

[Jm954 Administrator]

Well spotted! This is reported in more detail in my post from a few days ago

healthunlocked.com/cllsuppo...

Jackie

[Newdawn Administrator]

I consider myself very fortunate indeed to have been randomised to the I&V arm on the Flair Trial. Brilliant to read these outcomes.

Newdawn

[MovingForward4423 in reply to Newdawn]

I consider myself lucky to have been diagnosed at a stage when the disease treatments options have advanced so much. Let’s face it, 10 years back there was FCR and without the progress in targeted treatments, many of us would not be here today. Hats off to the researchers, doctors, nurses and admin staff that drive trials of new drugs. Also to individuals like Professor Peter Hillman who dedicated their lives to making life better for sufferers of CLL and other leukaemia’s.

[Newdawn Administrator in reply to MovingForward4423]

Precisely why I feel so fortunate because I was diagnosed 11.5 yrs ago when FCR was really the only gig in town. I’m so glad I was able to have an extended wait period in order to allow this fantastic research to develop. My mutational status was never established as it came back ‘inconclusive’ twice.

However, despite the success of this arm of the trial (and others), reality has not been suspended and I’m certainly aware that CLL is not yet curable.

Regards,

Newdawn

[Skyshark]

I have to wonder what the future holds for those that failed to reach uMRD4 by year 3 and extended treatment to 6 years. At some point they will accumulate too many mutations and then either one or both drugs stops working, what then?

Against FCR it does very well but for UK NICE approval it's now got to show cost effectiveness against short term 12 cycles V+O and 15 cycles V+I. At about £100,000 a year that's a tall hill.

[johnliston in reply to Skyshark]

Skyshark, is the I+V treatment that is currently appoved in the UK for front line treatment fixed duration?

john

[MovingForward4423 in reply to johnliston]

nice.org.uk/guidance/ta891

[MovingForward4423]

They may still reach UMRD, but as we know CLL can be unpredictable and personalised, and not everyone will see the same results. Mutated disease, that always had a better prognosis is less responsive to these combinations compared to unmutated as the researchers discussed. However there is a myriad of new drugs on the horizon, most interesting is reversible BTK and advancements in Car-T that is seeming beginning to understand the challenges of T Cell exhaustion. CLL is one of the most common leukaemia’s so it gets a lot of focus from Pharma. However as these treatments get better and better, I fear Pharma interest will somewhat wain as new treatments become less profitable. There are a many on here that have a much better handle on the new treatments etc…who will probably respond.