Expert Review of Hematology

ISSN: 1747-4086 (Print) 1747-4094 (Online) Journal homepage: http://www.tandfonline.com/loi/ierr20

Highlights in the treatment of chronic lymphocytic leukemia from the 2013 meeting of the American Society of Hematology Stefano Molica To cite this article: Stefano Molica (2014) Highlights in the treatment of chronic lymphocytic leukemia from the 2013 meeting of the American Society of Hematology, Expert Review of Hematology, 7:2, 187-190 To link to this article: http://dx.doi.org/10.1586/17474086.2014.899145

Published online: 11 Mar 2014.

Submit your article to this journal

Article views: 53

View related articles

View Crossmark data

Citing articles: 1 View citing articles

Full Terms & Conditions of access and use can be found at http://www.tandfonline.com/action/journalInformation?journalCode=ierr20 Download by: [Chinese University of Hong Kong]

Date: 05 November 2015, At: 23:40

Downloaded by [Chinese University of Hong Kong] at 23:40 05 November 2015

Meeting Report

Highlights in the treatment of chronic lymphocytic leukemia from the 2013 meeting of the American Society of Hematology Expert Rev. Hematol. 7(2), 187–190 (2014)

Stefano Molica Department Hematology-Oncology, Azienda Ospedaliera Pugliese-ciaccio, Viale Pio X – 88100 Catanzaro, Italy Tel.: +39 096 188 3001 Fax: +39 096 188 3221 [email protected]

2013 American Society of Hematology Annual Meeting New Orleans, LA, USA, 7–10 December 2013 The American Society of Hematology Annual Meeting includes physicians, scientists, administrators, medical students, graduate students, allied health professionals and exhibitors. This year’s meeting was held in New Orleans, LA. Presentations included a wide variety of topics in benign and malignant hematology. This year new data in the treatment of chronic lymphocytic leukemia, with particular focus on high unmet need populations, such as patients ‘unfit’ for intensive chemo-immunotherapy have been presented.

Novel data on the treatment of chronic lymphocytic leukemia (CLL) have been presented at the 2013 American Society for Hematology (ASH) meeting. They have focused on high unmet need CLL populations such as patients ‘unfit’ for intensive chemoimmunotherapy. CLL is a disease mostly affecting the elderly, who are generally diagnosed at a median age of 72 years. Because the elderly are more likely to have comorbidities that compromise the ability to tolerate aggressive treatments, their management is a challenge [1,2]. Results of the CLL-11 and COMPLEMENT1 trials, presented respectively as plenary and oral abstracts at the 2013 ASH meeting, have addressed the issue of treatment with chemoimmunotherapy of elderly patients with CLL, and therefore, providing evidence that a change of current practice is feasible [3,4]. Thus far, only the German CLL-5, a randomized, prospective trial, had focused on the treatment of elderly CLL patients [5]. In brief, patients older than 65 years with an Eastern Cooperative Oncology Group 0–2 performance status were randomized to receive either fludarabine or chlorambucil. Despite the higher overall response rate (ORR) observed with fludarabine, no difference was informahealthcare.com

10.1586/17474086.2014.899145

observed in terms of progression-free survival (PFS) and overall survival (OS). Grades 3–4 neutropenia and infections were uniformly observed in the two arms [5]. Results of the CLL-5 study qualify chlorambucil as the backbone of treatment for elderly/unfit CLL patients; however, other therapies, such as bendamustine, which have been proven to be superior to chlorambucil in randomized controlled trials are currently under evaluation in this setting [6,7]. An association of rituximab and chlorambucil has been tested as first-line therapy of elderly/ unfit CLL patients in two Phase II studies [8,9]. However, clearcut implications to modify the daily practice of using chlorambucil alone in this subset of patients are absent. Results of both the CLL-11 and COMPLEMENT-1 Phase III clinical trials provide relevant insights into the role of anti-CD20 monoclonal antibodies when combined to a weaker chemotherapy backbone such as chlorambucil in patients with previously untreated CLL patients and coexisting conditions [3,4]. The CLL-11 trial is a randomized Phase III study planned to determine whether antiCD20 antibody-based (i.e., rituximab or obinutuzumab) chemoimmunotherapy including chlorambucil would be beneficial in patients

 2014 Informa UK Ltd

ISSN 1747-4086

187

Meeting Report

Molica

to under-represent the elderly patients with CLL in prior clinical trials [1,2]. Whether obinutuzumab is better than CLL-11 trial [3] COMPLEMENT-1 trial [4] rituximab in all CLL scenarios is not clear Patient population CIRS >6 and/or CrCl

Highlights in the treatment of chronic lymphocytic leukemia from the 2013 meeting of the American Society of Hematology.

The American Society of Hematology Annual Meeting includes physicians, scientists, administrators, medical students, graduate students, allied health ...
463KB Sizes 3 Downloads 3 Views