Posted on 05/12/2023 9:01:34 PM PDT by ConservativeMind
Chemotherapy has been the most effective treatment to date for young and fit patients with chronic lymphocytic leukemia (CLL). Research now shows that a chemo-free drug-combination therapy is more effective and produces fewer side effects.
The phase 3 randomized trial, also known as the GAIA/CLL13 trial, was conducted with a total of 920 fit patients with CLL in 159 hospitals in nine European countries and Israel. The patients were placed in four groups and received either chemotherapy and an antibody (standard treatment), or the drug venetoclax in combination with an antibody (either rituximab or obinutuzumab). The fourth group received venetoclax, obinutuzumab and the specific kinase inhibitor ibrutinib.
Importantly, in all four groups, the treatment was temporary, in contrast to earlier studies that continued either venetoclax or ibrutinib, which prolongs exposure to side effects, dramatically increases the costs and inevitably results in development of resistance.
All groups with venetoclax had fewer side effects, and that the combinations of venetoclax with obinutuzumab were more beneficial than the standard treatment with chemotherapy. Treatment was specifically discontinued in patients with an aggressive form of the disease (so-called IGHV unmutated variant, which resolves in 50% of patients).
On average, after 3 years in the more aggressive disease group, in 35% of those who received chemotherapy, the disease had returned. For those who received the experimental combination therapy, this was only 18%. Making the combination therapy twice as effective for this group.
Until now, chemo-immunotherapy has been the most effective treatment for patients with treatment continuing indefinitely. With drug-combination therapy it is now possible to stop treatment after a year.
"This study shows that with clever temporary and safe combinations, you can allow patients to be treatment free in the long-term, with a much lower chance of developing resistance," says Kater.
(Excerpt) Read more at medicalxpress.com ...
Hoping it does well for him. Targeted immunotherapy is the way to go if available and will eventually replace standard chemo for a lot of diseases. It is one of the most exciting areas of research right now
As always, with most complex situations, the devil is in the details. In this case, your life is in the details.
Anyone with blood cancer and/or lymphoma should seek, at a minimum, a second opinion from a top research center. There are probably only about five of these who have world-class research facilities, diagnostic capabilities, and specialized physicians to diagnose the particulars of these cancers with all their various mutant variations. Only with a proper diagnosis can a proper treatment be formulated. There is no one size fits all or "cookbook treatment," which is what you will normally get from a local or regional ONC.
Going to a local or regional ONC doctor is like taking your Mercedes 500 to a local shade tree mechanic -- accept it's your life at stake.
My choice for a top cancer center was the #1 rated cancer center in the country: MD Anderson. It saved my life.
Well said.
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