New targeted therapy options headlined this year’s American Society of Hematology meetings in New Orleans this year. One example: new drugs for chronic lymphocytic leukemia (CLL) that are more effective and better tolerated.
According to Jennifer R. Brown, MD, PhD, Director of the Chronic Lymphocytic Leukemia Center at Dana–Farber Cancer Institute in Boston, “These exciting developments in CLL therapy represent a shift toward treatments that hone in on specific regulators of cancer, ultimately providing a safer and more effective treatment regimen.”
Dr. Brown continued, “These data give us even more reason to believe that the future outlook for CLL patients is bright.”
Each day at ASH, journalists are called together for a press conference featuring highlights from the meetings. This info is from Sunday’s press gathering:
CLL is a blood cancer that occurs when abnormal white blood cells called lymphocytes accumulate in the blood, bone marrow, and lymph nodes or other organs, causing these organs to enlarge. Approximately 15,000 Americans are diagnosed with CLL every year, and nearly 70 percent of those affected are 65 or older. For some patients with a slower progressing disease, many physicians employ “watch and wait” strategies to minimize unnecessary toxic treatments. However, patients with high-risk features or a more rapidly progressing disease require prompt treatment.
While the current standard chemotherapy-based treatment regimen for patients with CLL has been effective in improving outcomes for these patients, it remains highly toxic, prompting additional research to identify strategies to further reduce the treatment burden. Newer drugs that more precisely target pathways and proteins known to trigger CLL development, and leave normal cells unharmed, are proving to be more effective in promoting cancer cell death while safer for the patient. Three studies presented today reveal data on the performance of several new CLL therapies that demonstrate potent effects on key regulators of cancer cell behavior:
1) A commonly used combination treatment for CLL today consists of chemotherapy and rituximab, a synthetic molecule engineered to target a protein on the surface of CLL cells (CD20). While effective, rituximab has less potency in CLL than in other cancers, and chemotherapy used in combination with rituximab may not be well tolerated among elderly patients. In an effort to improve treatment options for CLL patients, investigators conducted a head-to-head comparison of rituximab and obinutuzumab (GA101), a novel monoclonal antibody engineered to attack CD20, but hypothesized to have more potent anti-leukemic effects.
“Our results suggest that GA101 may be a stronger CD20 antibody than rituximab. This could lead to a potential decrease in the total amount of chemotherapy required for an effective combination regimen, translating to less toxicity for the patient,” said study author Valentin Goede, MD, of University Hospital Cologne in Germany. “While we will continue to evaluate these results through a longer follow-up period, these findings suggest that GA101 has the potential to eventually replace rituximab for the care of CLL patients.”
2) “The combination of idelalisib/rituximab appears to offer quite a significant improvement in progression-free and overall survival over rituximab and placebo,” said study author Richard R. Furman, MD, of Weill Cornell Medical College in New York. “We’re particularly excited to see these results among this subset of patients who have been heavily treated and are unfit for additional chemotherapy. Given the efficacy and low risk for long-term toxicities demonstrated, we believe this treatment could be applicable to all CLL patients because it eliminates the need for chemotherapy.”
3) “Our study results suggest that IPI-145 may lend itself well to long-term therapy of patients with CLL,” said study author Ian Flinn, MD, PhD, of Sarah Cannon Research Institute in Nashville, Tenn. “While it has a well-tolerated profile similar to other drugs in its class – it may actually be more potent, which could contribute to its value for patients with relapsed or refractory disease in particular.”
The feeling I got? The current standard of care for CLL, rituxumab, may soon be replaced by several new, innovative therapies. Good news for CLL survivors!
This is an example of how therapy innovations are working against a wide variety of blood cancers. Most have become what oncologists call “chronic.” Patients that may have died in a few short years decades ago are now living 10, 15 or 20 years. Some are even considered cured.
This news is an example of what ASH is like. A lot of very technical data, designed to help researchers and doctors try and figure out which drugs are working and why.
My cancer, multiple myeloma, is considered one of the most difficult to treat of all blood cancers. Yet even myeloma is hoped to soon be considered chronic for a majority of patients. While that may still be 5-10 years away, I have already lived 3 years longer than my doctors predicted I would.
I’ll share more specifics in a day or two as things wrap up here in New Orleans.
Feel good and keep smiling! Pat