A review of treatment approaches in CLL

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Published: 30 Sep 2013
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Prof William Wierda - MD Anderson Cancer Center, Houston, Texas, USA

Professor Wierda from MD Anderson Cancer Center, Houston, Texas, USA, outlines to ecancer the highlights from the iwCLL 2013 session entitled ‘Traditional treatments’.  This session explored initial chemoimmunotherapy approaches for young and old, the clinical trials on-going in this area, and what alternatives to initial chemoimmunotherapy might be.  It also gave the audience advice on the important question of how to approach relapsed CLL if no clinical trial is available.  Professor Wierda shares his highlights from these presentations.

Please highlight the main points from the session you chaired at the iwCLL 2013 entitled ‘traditional treatment’

There were several speakers in the first session this morning.

It started with Michael Hallek who gave an update and an impression of where we’re going with chemo-immunotherapies, both for the elderly population and for the young, fit patient.

He gave some update on the German CLL study group and where they’re going with their clinical trials and gave us an idea of what data to expect.

He mentioned the randomised FCR versus BR trial that we’ll be hearing probably about at either ASH this year or next year as well as what their plans are for future trials, a trial that they’re doing with lenalidomide as a maintenance strategy for patients following chemo-immunotherapy.

The second speaker was John Byrd.

John Byrd gave us a perspective and an update on this new class of molecules that are in development for CLL and some of the highlights of the activity of these agents and also the tolerability and had a discussion about how he thought these may fit into treatment and management for patients with CLL.

The most impressive part about his lecture was something that I’ve been thinking a lot about is how really are we going to work these agents in to management for patients with CLL. I think the most important thing we need to focus on is obviously making a difference and impacting their quality of life as well as their survivability.

So it’s going to be a challenge for us, it’s a great challenge that we have that we have this new class of drugs that we’re needing to work on learning how to best incorporate them into the management of our patients in order to give our patients the best outcome.

As John finished his talk Thaddeus Roeback gave an overview; the topic of his lecture was a question that we commonly get as academicians giving talks about therapies for CLL, that is what do you do with difficult patients who you don’t have a clinical trial for.

Not difficult… patients who have difficult disease to treat who you don’t have a clinical trial for.

So he did a very comprehensive review of a variety of regimens and treatments that have been studied in patients with CLL, front line studies and salvage studies.