iwCLL 2013: Dr. Jeff Sharman Gets Down to Discussing How He Treats Patients with High Risk Disease
In Part 3 of our conversation from iwCLL 2013, Dr. Jeff Sharman talks about how he approaches a patient with 17 p deletion.
This touches on the thorny issue of clonal evolution and the concern that treatment might lead to a Darwinian selection of the fittest, in this case the most resistant and probably the nastiest sub-clone of the CLL bunch.
Still, Dr. Sharman points out how the new biological treatments may force us to reexamine (and I do mean examine in a formal one) our long held beliefs about the inadvisability of early treatment.
Some of the new kinase inhibitors such as ibrutinib and idelalisib seem to have less of this risk, as they seem nearly as active on the high risk clones as in the more wimpy cancer cousins.
But there remains too many gaps in our knowledge to know what is the right thing to do, but we are moving forward at a rapid clip. And what may seem the best choice today, will certainly be different tomorrow.
Here's Dr. Sharman in part 3 from Cologne, Germany. If you haven't seen part 1 and 2 of the interview, please scroll down to the two prior posts.
More to come soon.
PS: I love the comment that my tie looks like gene sequencing. That made my day.
This touches on the thorny issue of clonal evolution and the concern that treatment might lead to a Darwinian selection of the fittest, in this case the most resistant and probably the nastiest sub-clone of the CLL bunch.
Still, Dr. Sharman points out how the new biological treatments may force us to reexamine (and I do mean examine in a formal one) our long held beliefs about the inadvisability of early treatment.
Some of the new kinase inhibitors such as ibrutinib and idelalisib seem to have less of this risk, as they seem nearly as active on the high risk clones as in the more wimpy cancer cousins.
But there remains too many gaps in our knowledge to know what is the right thing to do, but we are moving forward at a rapid clip. And what may seem the best choice today, will certainly be different tomorrow.
Here's Dr. Sharman in part 3 from Cologne, Germany. If you haven't seen part 1 and 2 of the interview, please scroll down to the two prior posts.
More to come soon.
PS: I love the comment that my tie looks like gene sequencing. That made my day.
Labels: 17p deletion, Chronic lymphocytic leukemia, CLL, Dr. Sharman, ibrutinib, Idelalisib, interviews, iwCLL 2013, Treatment decisions. Clinical trial, Video
posted by Brian Koffman at
10:07 PM
4 Comments:
Does the percentage of p53 deletion, for example 10%, 20%,40%,60% affect the decision making as to what treatment to use and when?
What a treat to watch and listen from two the people I most enjoy hearing from chatting about the changing CLL landscape. Always something new, interesting and valuable. Thank you for all you do.
Hope you are doing and feeling well Brian.
Thank you for all you do for the good of mankind.
What causes 17 p deletion. My husband had CLL with 17 p deletion and died six days after his 51st birthday. He died six years ago today, 2 years and 9 months after diagnosis. I have 4 kids ranging in age from 17 to 27. One has already had testicular cancer but is five years cancer free this month. Is 17 p deletion likely to cause problems for my children or does its cause stem from something environmental?
Post a Comment
Subscribe to Post Comments [Atom]
<< Home