Saturday, January 5, 2013

ASH 2012: Dr. John M. Pagel Part 2: Present Trials and Speculations on the Near Future of Ibutinib, GS-1101, ABT-199, GA-101, TRU-016 including Combinations and the Changing Role of Transplants

I am grateful for the thoughtful, caring and careful way Dr. John Pagel tells the evolving story of CLL treatment. But I am also grateful that he is willing to speculate about what the future might hold for us CLL patients and those yet to be diagnosed.

In the follow-up to Part 1 of my interview, Dr. Pagel hypothesizes a possible future of the "game changing" emerging therapies in CLL, their paths to probable approval, logical combinations, available and coming trials, the "boots on the ground" reality of how they will be used on and off label, and the reassessing of the time and place for allogeneic transplants.

His candid observation that drugs such as ibrutinib (PCI-32765) and GS-1101(now idelalisib and formerly CAL-101) will potentially be used extensively "off label" and upfront in therapy is in my opinion, a realistic take on what is coming to the next generation of CLL patients.

When he talks about the shifting role of allogeneic transplants, we hear his wisdom and experience gained from his years of helping patients in both the pre and post imatinib (Gleevec) eras.

He informs of us the logical combinations of agents, many with no cytotoxic chemotherapy to be found anywhere in the treatment protocol, that are available right now in clinical trials and will continue to be explored.

Please be sure to view Part 1 if you haven't already. It will help with the context of this continuation of the same interview. In Part 1, there is more indepth discussion of ABT-199. In Part 2, presented below, I start by asking him about the other two big names out there ibrutinib (PCI-32765) and idelalisib (GS-1101), and he picks up from there. 

There will be a brief Part 3 soon that will deal with transplants exclusively.

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Anonymous Anonymous said...

Wow fascinating Brian, and if you don't mind me saying, as a former BBC News TV producer - I think you could easily switch careers! Great job - thanks for doing this, and I really look forward to seeing part 3. So bummed that I start FCR this week - wish a chemo naive trial was opening up in Australia imminently! Best wishes, Deborah in Melbourne

January 6, 2013 at 3:07 AM  
Anonymous Anonymous said...

18 months possible approval? That's wonderful!! Optimistic yes! That's what keeping me going. Seems that I was dx with CLL at the right time in this new era of new drugs and treatment options. Thanks for your informative blogs and interviews.

January 6, 2013 at 9:11 AM  
Anonymous Anonymous said...

Great interview Brian . I'm doing well after finishing FCR last August but I would prefer an alternative next time round if at all possible as my immune system is low to non-existant . This is so hopeful and I have my fingers crossed for a long enough remission .

January 8, 2013 at 7:55 AM  
Anonymous Anonymous said...

WOW. This is just great news!
Makes me wish I would have been DX a few eyars later and hadn't already done FCR but it is equally comforting to know these options exist to delay or prevent the need to do the risky alloBMT. I wonder if any of the researchers have considered how these new agents might fit in to trying the less risky AutoBMT? Pehaps as a post auto transplant attempt to rid the MRD??

January 8, 2013 at 2:04 PM  

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