Chronic lymphocytic leukemia · 2020-01-19 · Hematology. IOSI - Oncology Institute of Southern...
Transcript of Chronic lymphocytic leukemia · 2020-01-19 · Hematology. IOSI - Oncology Institute of Southern...
HematologyIOSI - Oncology Institute of Southern Switzerland
IOR - Institute of Oncology ResearchUSI – Universita’ della Svizzera Italiana
Bellinzona - Switzerland
Davide Rossi, M.D., Ph.D.
Chronic lymphocytic leukemia
Conflict of interest
Research Support:Janssen, Gilead, Abbvie, AstraZeneca, Cellestia,
Xeneticbio
Employee No
Consultant No
Major Stockholder No
Speakers Bureau No
Honoraria Gilead, Abbvie, Janssen, Roche, AstraZeneca, Loxo
Scientific Advisory Board Gilead, Abbvie, Janssen, AstraZeneca, MSD, Loxo, Verastem
First-line setting
• ELEVATE TN study
• CLL14 update
Results from ELEVATE TN study
Results from ELEVATE TN study
Results from ELEVATE TN study
Results from ELEVATE TN study
Results from ELEVATE TN study
Results from ELEVATE TN study
Results from ELEVATE TN study
Follow-up data from CLL14
CLL14 study design
CLL14: patients’ characteristics
Follow-up data from CLL14: PFS at 39.6 months
Follow-up data from CLL14
Follow-up data from CLL14: IGHV status
Follow-up data from CLL14: TP53 disruption
Follow-up data from CLL14: OS
Follow-up data from CLL14: MRD by ASO-PCR
Follow-up data from CLL14: MRD by NGS
Follow-up data from CLL14: MRD longitudinal evaluation
Follow-up data from CLL14: MRD and PFS
Follow-up data from CLL14: MRD and PFS
Follow-up data from CLL14: conclusions
Relapsed/refractory setting• MURANO update
MURANO study: updated analysis at 48 months
MURANO study: patients’ characteristics at baseline
MURANO study: updated analysis at 48 months
MURANO study: updated PFS analysis at 48 months
MURANO study: MRD status at EOT
MURANO study: EOT uMRD correlates with PFS
MURANO study: updated analysis at 48 months
MURANO study: OS benefit post-EOT
MURANO study updates
MURANO study updates
MURANO study updates
MURANO study updates
MURANO study updates
Question 1
Progressive previously untreated CLL patient, unfit, withconcomitant cardiac conditions, IGHV unmutated status, TP53 wildtype, limitations in logistics. What treatment would you consider asfirst choice (irrespective of reimbursement status in CH)?
1. Ibrutinib (+/-G)2. Clb+G3. VenG4. Acalabrutinib+G
Question 2
Progressive previously untreated CLL patient, unfit, withoutconcomitant cardiac conditions, IGHV unmutated, TP53 wild type,limitations in logistics. What treatment would you consider as firstchoice (irrespective of reimbursement status in CH)?
1. Ibrutinib (+/-G)2. Clb+G3. VenG4. Acalabrutinib+G
Question 3
Progressive previously untreated CLL patient, unfit, , withconcomitant cardiac conditions, IGHV unmutated status, TP53 wildtype, without limitations in logistics. What treatment would youconsider as first choice (irrespective of reimbursement status inCH)?
1. Ibrutinib (+/-G)2. Clb+G3. VenG4. Acalabrutinib+G
Question 4
Progressive previously chemoimmunotherapy treated CLL patient,TP53 wild type, PR with detectable MRD after 2 years of VenR.Which approach would you consider now (irrespective ofreimbursement status in CH)?
1. Stop treatment and watch and wait until clinical progression2. Switch to BTKi3. Maintenance with Venetoclax monotherapy4. Depends of MRD kinetics under Venetoclax treatment