Wednesday, May 13, 2015

ASCO 2015 - CLL

The new ASCO abstracts are out.  After going to this meeting regularly for over 10 years, I only now feel like I know how to approach it.  I am also struck more and more by the sheer volume of data that comes out at ASH and the comparatively small quantity of CLL/NHL data at ASCO.  Of course now we have SOHO (Society of Hematologic Oncology) and the new ASH September meeting to directly compete with SOHO.  Don't forget about IWCLL (in Sydney this year) and ICML (Lugano) and EHA (European Hematology Association).  If I went to all these meetings, I think my colleagues would fire me from my practice because I couldn't hardly see patients.

I thought I would highlight the CLL / NHL abstracts that I think are the most compelling and offer a sentence about each one.  I will get the CLL ones out tonight and then work on NHL in next few days.

Duvelisib in untreated CLL - Small number of patients, but decent activity.  Not a ton of LFT discontinuations

Use of molecular prognostic testing in clinical practice - Shameful how little people use FISH

ROR1 small molecule inhibitors - could be wrong, but I suspect this could prove to be a big deal

TGR-1202 in CLL/NHL - No LFT abnormalities with PI3K inhibitor?  Curious

Ofatumumab +/- Idelalisib - Another strong phase 3 result.  Might anticipate another FDA indication

Bleeding rates on Idelalisib - Attacking one of ibrutinib's few weak spots

CLL prognostic index - first the IPI, then the FLIPI and MIPI, now the CLL-IPI

Ibrutinib dose intensity and outcome - Importance of not skipping doses.

Bendamustine / Rituximab +/- Ibrutinib in relapsed CLL - late breaking.  No data, but there is a press release - linked here

Relatively few practice changing data sets out there.  FDA will probably act on the two phase 3 studies here and expand labeled indications, but I don't really think many patients with relapsed CLL are going to be affected by the BR +/- ibrutinib study because everyone wants to take ibrutinib as a single agent.  The Ofa +/- idela might have some traction, but the more ofa data I see, the more I think it is just another rituximab - and we've already had positive phase 3 results and FDA approval.


  1. I'm surprised you didn't mention the 1101, 1202, and Ibrutinib combo?

    1. Yes, interesting combo with lots of potential. I want to see a little more data before it makes my list. This is very early, but clearly where things are headed.


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