{"id":14849,"date":"2020-11-03T12:50:23","date_gmt":"2020-11-02T23:50:23","guid":{"rendered":"https:\/\/clladvocates.nz\/?p=14849"},"modified":"2020-11-03T12:50:23","modified_gmt":"2020-11-02T23:50:23","slug":"different-therapies-and-modalities-for-treatment-of-cll-in-the-second-line","status":"publish","type":"post","link":"https:\/\/clladvocates.nz\/?p=14849","title":{"rendered":"Different Therapies and Modalities for Treatment of CLL in the Second Line"},"content":{"rendered":"

[vc_row row_height_percent=”0″ override_padding=”yes” h_padding=”2″ top_padding=”3″ bottom_padding=”3″ overlay_alpha=”50″ gutter_size=”3″ column_width_percent=”100″ shift_y=”0″ z_index=”0″][vc_column column_width_percent=”100″ gutter_size=”3″ overlay_alpha=”50″ shift_x=”0″ shift_y=”0″ shift_y_down=”0″ z_index=”0″ medium_width=”0″ mobile_width=”0″ width=”1\/1″][vc_custom_heading heading_semantic=”h1″ text_size=”h1″]Different Therapies and Modalities for Treatment of CLL in the Second Line<\/b>[\/vc_custom_heading][vc_column_text]<\/p>\n

This article was originally published on Targeted Oncology<\/a><\/p>\n

During a\u00a0Targeted Oncolog<\/em>y Case Based Peer Perspectives event,\u00a0Danielle Brander, MD, a<\/strong>ssistant professor of Medicine at Duke Cancer Institute in Durham, NC, discussed options for treating a 53-year-old female patients with chronic lymphocytic leukemia (CLL).<\/p>\n

Targeted Oncology<\/em>\u2122: What are the guideline-recommended regimens to treat a patient with CLL such as this one?<\/strong><\/p>\n

BRANDER:\u00a0<\/strong>The [National Comprehensive Cancer Network] guidelines for regimens in the relapsed\/refractory setting include acalabrutinib [Calquence] and venetoclax [Venclexta], which are approved in all lines of therapy. In the relapsed\/refractory setting, there\u2019s also approval of duvelisib [Copiktra] and idelalisib [Zydelig], which are PI3K inhibitors.1<\/sup><\/p>\n

What data support the use of ibrutinib (Imbruvica), which is another guideline-recommended agent for the treatment of this patient?<\/strong><\/p>\n

The data that led to the initial approval of ibrutinib was the RESONATE trial [NCT01578707]. [The trial] randomized patients 1:1 to either ibrutinib or the anti-CD20 antibody standard-of-care agent in the relapsed\/refractory setting, ofatumumab. Patients were allowed to cross over on this study.2<\/sup><\/p>\n

There are now 6-year follow-up data [showing that the] median progression-free survival [PFS] for the ibrutinib arm was not reached but was short [8.1 months] for the ofatumumab alone [HR, 0.133; 95% CI, 0.099-0.178].<\/p>\n

Markers [of prognosis] that would indicate inferior response to chemoimmunotherapy are either the patients with\u00a0IGHV\u00a0<\/em>unmutated or del(17p) or del(11q), who are still having good responses. This is in the relapsed\/refractory setting with novel agents.<\/p>\n

The grade 3 or greater AEs [adverse effects] that you\u2019ll see are infectious complications. Infections and neutropenia do get better in terms of incidence with [time]. But obviously, if they have to stop [treatment] in the first year, it\u2019s still detrimental to them. One thing [to keep in mind when] monitoring patients is that time on therapy does increase risks for hypertension. Atrial fibrillation and bleeding remain a risk throughout treatment. Often, they first appear early on treatment.<\/p>\n

To continue reading this article on Targeted Oncology\u00a0<\/a>[\/vc_column_text][\/vc_column][\/vc_row]<\/p>\n<\/div>","protected":false},"excerpt":{"rendered":"

During a Targeted Oncology Case Based Peer Perspectives event, Danielle Brander, MD, assistant professor of Medicine at Duke Cancer Institute in Durham, NC<\/p>\n","protected":false},"author":1,"featured_media":14850,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_monsterinsights_skip_tracking":false,"_monsterinsights_sitenote_active":false,"_monsterinsights_sitenote_note":"","_monsterinsights_sitenote_category":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[17,23],"tags":[],"class_list":["post-14849","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-featured","category-research"],"jetpack_featured_media_url":"https:\/\/clladvocates.nz\/wp-content\/uploads\/2020\/11\/Danielle-Brander-MD.png","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/posts\/14849","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=14849"}],"version-history":[{"count":1,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/posts\/14849\/revisions"}],"predecessor-version":[{"id":14851,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/posts\/14849\/revisions\/14851"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=\/wp\/v2\/media\/14850"}],"wp:attachment":[{"href":"https:\/\/clladvocates.nz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=14849"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=14849"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/clladvocates.nz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=14849"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}