June 21, 2011 - CLL Update - Emerging Therapies
Date: June 21, 2011
Time: 12:00 p.m. - 1:00 p.m. ET
Read: CLL Spotlight | Transcript | Transcript (Spanish)
Download: Program Slides | Program Slides (Spanish)
Listen: Presentation | Q&A Session | Presentation (Spanish) | Q&A Session (Spanish)
- Tests used to diagnose CLL
- Determinants of individual CLL patient's treatment needs
- Current and emerging treatments for CLL patients
- The role of clinical trials in the continuing improvement of CLL treatment
- CLL side effects management
Susan O'Brien, MD
Professor of Medicine
Chief, Section of Acute Lymphocytic Leukemia
Department of Leukemia
The University of Texas MD Anderson Cancer Center
The excitement of these two drugs (CAL-101 and PCI-32765) is that they're oral, they have very little in the way of side effects, they don't suppress the immune system like chemotherapy does and it's very exciting to have them available now in clinical trials and to use also in combination, because it's unlikely we're going to cure any patient with a single drug. But as we get to better and better combinations, a cure may become more likely. And of course, that's really where we would like to go, is to be able to cure this disease, not just get it into remission for many years, which we can often do, but really cure it once and for all.
Dr. O'Brien discusses the newest drug and treatment options as well as new opportunities unfolding to treat CLL patients. Dr. O'Brien answers audience questions during the interactive segment of the program.
- CAL-101, an oral drug, is in Phase I trials, which is typically a trial that looks at a new drug's appropriate dose.
- In one trial for CAL-101
- Patients with a median number of five prior therapies were treated with the drug at various dose levels. Toxicities included some nausea and some indigestion. It was a very well tolerated drug and patients could take it for long periods of time.
- At a two-month follow-up CAT scan, every patient in the trial showed shrinkage in their lymph nodes, some as much as 100 percent.
- In combining CAL-101 and rituximab (Rituxan®), patients are provided a combination that doesn't lower the immune system as much as chemotherapy.
- PCI-32765, an oral therapy, is in clinical trials for CLL treatment.
- In one trial for PCI-32765
- 20 percent of the patients had a 17p deletion, a high risk group. These patients were slightly less heavily pretreated than in the CAL-101 trial.
- After treatment with PCI-32765, at the first evaluation point in the trial, patients saw dramatic changes in the lymph node size and zero patients had progressive disease.
- PCI-32765 was a well tolerated drug. The most common toxicity was diarrhea, but that was usually easily controlled. In many cases patients stayed on the drug and the diarrhea went away on its own.
Questions Asked by the CLL Community
- Are there any other immunotherapies not covered in this presentation that could be explained?
- How does one get involved in clinical trials for either of these two new drugs (CAL-101 or PCI-32765)?
- Are there any recent findings or new treatments for hairy cell leukemia?
- How many times can a patient receive transfusions?
- Are there any medications that could be taken to avoid a decrease of platelets?
- Does eating a vegan diet affect the progression of CLL?
- At what stage would a CLL patient be a candidate for drug therapy?
- Is stem cell transplantation an option for a cure?
- Unlike what happens with other cancers, why is early diagnosis of CLL not an advantage for treatment?
- What has been the effect on the platelet count for relapsed patients during the CAL-101 and Rituxan® clinical trial?