This
week on the CLL Society website, I present my contrarian thoughts on the “bright future”
for those of us with CLL.
We have
all heard repeatedly how bright the future is for those of us patients these
days and we have heard it because it’s absolutely true.
We have
MUCH better drugs that work for both those us at high and low risk and these
new compounds generally have fewer side effects than traditional chemotherapy.
We are starting to understand the biology of our cancer and that is being
translated into more individualized and targeted therapies.
But my
concern and that of many of the researchers that I spoke with at the large
gathering of CLL experts from around the world at iwCLL 2015 in Sydney,
Australia was that we might be victims of our success.
Because
drugs such as ibrutinib and idelalisib and obinutuzumab are already approved in many
countries and offer pretty spectacular results, pharmaceutical companies may be
less willing to invest the billions of dollars it takes to bring a new drug to
market. New meds likely will need to demonstrate superior results to existing
therapies or meet an unmet need or treat a small unserved niche of patients or
be lower cost to be approved and adopted by the CLL community.
Because
of our amazing recent successes, research funds may start to dry up in CLL, with
funders seeing it as a mostly solved problem.
To
which I say: HOLD ON!
- We
don’t know how long we must stay on these new wonder drugs. We also don’t know
how long they will work.
- Are
there sequential or combination therapies that make more sense and will allow
us to eventually stop taking these expensive therapies?
- We
still have no good answers for most cases of Richter’s transformation.
- Most
importantly, none of us are cured. Except perhaps for a lucky few allogeneic
transplant patients. Let’s cure our CLL.
More
research and more money will be needed to answer these and other critical questions.
Please
take a look at my ramblings and my short video recorded at the end of the
science meeting in Sydney here.
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always we provide all our content with no need to sign in, but I urge you to
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Labels: bright future, iwCLL 2015, Video
1 Comments:
Hi Dr Koffman my question is how does imbruvica work on refactory CLL with TP53, Notch1, BCOR, XPO1 mutations?
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