Hematologic Oncology Update, Issue 1, 2016 (Video Program)Incorporation of venetoclax into the treatment algorithm for patients with del(17p) CLL
1:43 minutes.
TRANSCRIPTION:
DR LOVE: So venetoclax is fast tracked by the FDA in 17p. And I think there’s another fast-track designation. If the drug were to become available, or if it were available right now, how would you incorporate it into your practice? DR LEONARD: I think I would be probably using it in people later in the course of the disease right now as a single agent. And then I think once we start to see more data, which we will see before long, are the combinations. Then it’s going to come down to what does it add to the combination versus the toxicity and the challenge of giving it? Ultimately, I think that we’ll probably end up with these regimens that are some sort of chemotherapy debulking followed by venetoclax or some overlapping with the chemotherapy and venetoclax. And the question then will be, what does the venetoclax add? But there’s no doubt that in some refractory patients it does have value and can work in resistant disease. DR LOVE: What is the thinking in terms of the potential to combine venetoclax and ibrutinib? I mean, they are different mechanisms. Do we know anything about that? DR LEONARD: Yes. I think those are studies that are getting underway. I think it certainly makes sense on an empiric basis. The question is really going to be, how do you demonstrate benefit? Are we doing randomized trials of ibrutinib alone versus ibrutinib combinations? There have been some chemotherapy combinations with ibrutinib also that are underway. So I think these are good problems to have. But at the end of the day, we’re going to need the randomized trials of these combinations versus the single agent. And then the question is, do you use them concurrently or do you use them in sequence, one after the other? |