Dr. John Pagel, from the Seattle Cancer Care Alliance, discusses the advances that
signal a potentially changing treatment landscape in CLL Pagel explains some of the new drug
therapies, including insights from ASH 2012, that may mean a move away from chemotherapy
for some patients.
Ibrutinib, GS 1101 and ABT-199 are changing the CLL treatment landscape, plus antibody
therapies such as GA 101 and novel therapies such as TRUO16 and the exciting T cell mediated therapies in research CART etc. All of these are moving away from toxicity treatments for the future.
Interesting times, The New Clinical Trials will be discussed with us at Cardiff in January by Professor Chris Fegan a clinical trials expert.
Yes, it dropped in my mailbox at 6.30 this morning.
Such exciting and encouraging news!! Especially with the other developments. T cell therapy was featured on TV this week, used on a little girl who is now free from Leukaemia (but only after problems with 'the overactive' t cells). Am I right that this isn't in trials yet?
I spoke to consultant about maybe going on a trial for Ibrutinib, or Ibrutinib+R when the time comes for treatment. I certainly feel far more optomistic now about the longer term future.
T cell therapies are highly experimental. They may one day replace stem cell transplant, but due to the costs involved they will never be standard of care... even with a huge economy of scale. And there certainly are road blocks to be overcome still, but some are slowly falling.
Should be found as a cure or even life long control over the next few years, then perhaps this will change, no crystal balls.
CAR T19 is in two pilot clinical trials, and MDAnderson plans a new trial for a CAR target called ROR1. The big advantage for this target is it is selective to malignant B cellls and much less selective to good B cells, the CLL 'holy grail'. CART 19 kills all B cells like rituximab, GA101 etc... wiping the B cell immune response.
However, I think the future is very bright, still distant...and cost will dictate all... especially in the UK and Canada for example...
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Richter's Transformation: standardized therapy or clinical trial
