Friday, September 25, 2015

The Work Needed to Maintain our " Bright Future" with CLL (chronic lymphocytic leukemia)

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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Blogger Unknown said...

Hi Dr Koffman my question is how does imbruvica work on refactory CLL with TP53, Notch1, BCOR, XPO1 mutations?

October 27, 2015 at 6:32 PM  

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