Tuesday, December 11, 2012

ASH 2012: CLL Highlights

I am still traveling, now in Ohio staying with friends for my OSU clinic visit with Dr. Byrd tomorrow. I am expecting that my mildly elevated neutrophils on my last blood draw will turn out just be an unexplained blip. I have other results from that prior visit that I need to discuss here too, but my personal story needs to take a backseat to the wonderful news from ASH for now.

I also have a photo shoot with the doctor, so I need my rest to look my best. More on that later.

When I am home, I will report in much greater detail on ASH 2012, Atlanta, GA, but I want to rush the news out about the big picture as soon as possible, so let me share some overarching highlights as I see them without the stats and scientific explanations behind them.
  1. There has never been a year like this for those of us with CLL.
  2. There is a palpable excitement and consensus among all the CLL doctors that treatment is radically changing for the better: a paradigm shift in therapy with the end of most chemotherapy possible in the next few years.
  3. These new players are mostly oral therapies and are NOT traditional killers of rapidly dividing cells as is traditional chemo, but rather targeted biological drugs.
  4. The stars of this sea change are GS1101 (formerly CAL-101), ibrutinib (formerly PCI-32765). and probably the least publicized member of this triumvirate, ABT-199 (a Bcl-2 blocker with amazing but less mature results).
  5. Responses rates with these drugs in all comers, including the worst of the worst (think 17p del and refractory patients), are nothing short of astounding with progression free survivals in some treatment naive cohorts at 96% at about two years.
  6. Responses get better, not worse, the longer we take these meds.The Kaplan-Meir curves are not falling. Relapses are remaining rare events, al least in the short term. We need longer follow-up for sure, but there is no signal that trouble is brewing,
  7. Side effects are minimal and may actually decrease the longer we are on the medications.
  8. The bone marrow is spared and infections at least with ibrutinib are not increased. Blood counts may actually improve with treatment.
  9. With ibrutinib, there is some reason to believe immunity might improve
  10. The data keeps just keeps getting better and better.
Much more to share about CAR-T, "off the shelf" CAR-T, GA-101, lenalinomide, the benefits of ASA and curcumin, and new encouraging data on 11q del, but I am badly sleep deprived so I am quitting here. Plus I need my beauty sleep for my photos.

Trust me that when I do fill in the details you will feel the same excitement that I felt humming in the air in Atlanta.

There is never a good time to get CLL, but there has never been a better time to get CLL.

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Anonymous Anonymous said...

Bravo Brian! Great gifts these days in CLL. As an ABT-199 trial participant ...I completely share your excitement!! So much HOPE! Thanks for being there and reporting back! Stay well. Wendy

December 12, 2012 at 8:05 AM  
Anonymous jcleri@aol.com said...

Hum.....a model in our midst?

December 12, 2012 at 8:26 AM  
Blogger Unknown said...

so pleased to hear of exciting developments in other cancers.
in cold London

December 12, 2012 at 8:27 AM  
Anonymous Anonymous said...

Thank you for bringing us this wonderful news!

December 12, 2012 at 9:22 PM  
Anonymous Anonymous said...

During my 4-mo checkup with my hem/onc yesterday, I said something to the effect of "It's a great time to have CLL." To which he replied, "Sign everybody up." A little humor to keep things in perspective.

December 14, 2012 at 6:43 AM  
Blogger Skullgal said...

And just when I was getting ready to go shopping for wigs... the science and excitement around these developments are absolutely amazing. Although I don't need treatment yet, I know if and when I do, I'll feel proud to be helping medical science get that much closer to a full cure for CLL by taking these drugs!

December 18, 2012 at 1:57 PM  

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