Chronic Lymphocytic Lymphoma | Professor Dr Stephan Stilgenbauer - a podcast by Dr Neil Love
from 2019-09-25T15:48:34
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Chronic Lymphocytic Lymphoma, Issue 2, 2019 — Part 1: Our interview with Prof Stilgenbauer highlights the following topics as well as cases from his practice:
- Updated International Workshop on Chronic Lymphocytic Leukemia guidelines for diagnosis, indications for treatment, response assessment and management of chronic lymphocytic leukemia (CLL) (00:00)
- Genetic abnormalities in CLL; effects of p53 mutations and 17p deletion on prognosis and therapy (02:48)
- Design and eligibility for the Phase III CLL14 trial of venetoclax/obinutuzumab versus chlorambucil/obinutuzumab for patients with previously untreated CLL and coexisting medical conditions (05:42)
- Recent data from the Phase III iLLUMINATE, Alliance A041202 and ECOG-E1912 trials comparing ibrutinib-based regimens to chemoimmunotherapy as first-line treatment for patients with CLL (07:51)
- Results from the CLL14 trial comparing venetoclax to chlorambucil as an addition to fixed-duration obinutuzumab therapy for CLL (10:17)
- Management of disease relapse on the CLL14 trial; role of minimal residual disease (MRD) assessment in therapeutic decision-making (13:19)
- Dosing and administration of the recently FDA-approved first-line regimen of venetoclax and obinutuzumab; mitigation of risk for tumor lysis syndrome (16:03)
- Mechanism of action of venetoclax; role of renal function in the decision to administer this agent (17:02)
- Emerging data with the combination of ibrutinib or venetoclax with anti-CD20 antibodies (20:05)
- Del(17p) and/or p53 mutation status and the selection of therapy for patients with CLL (22:09)
- Role of bendamustine/rituximab in the management of CLL (26:43)
- Perspective on the efficacy of venetoclax/obinutuzumab versus ibrutinib as first-line therapy for patients with CLL (28:38)
- Case: A man in his mid-60s with del(17p) CLL and no IGHV mutation experiences a dramatic response to first-line ibrutinib (30:42)
- Prolonged lymphocytosis during ibrutinib therapy (33:20)
- Clonal evolution in CLL; importance of monitoring for del(17p) and p53 mutations before treatment initiation (35:35)
- Sequencing of ibrutinib and venetoclax for patients with CLL; tolerability and quality of life with ibrutinib versus venetoclax (36:59)
- Management of arthralgias associated with Bruton tyrosine kinase (BTK) inhibitors (40:25)
- Case: A woman in her mid-70s with del(13q) CLL and no IGHV mutation receives acalabrutinib after experiencing disease progression on multiple lines of therapy, including ibrutinib (42:15)
- BTK inhibitor-associated headaches and atrial fibrillation (44:18)
- Efficacy of ibrutinib versus acalabrutinib; ongoing Phase III ACE-CL-006 study comparing acalabrutinib to ibrutinib for previously treated, high-risk CLL (47:31)
- Case: A man in his late 70s with del(11q) CLL and no IGHV mutation attains a complete response and MRD-negative status with venetoclax and obinutuzumab on the Phase III CLL14 trial (51:59)
- Side effects of venetoclax/obinutuzumab (53:36)
- Case: A man in his early 70s with hairy cell leukemia (HCL) and a BRAF mutation experiences disease progression after receiving vemurafenib as second-line therapy (57:25)
- Activity and tolerability of the recently FDA-approved antibody-drug conjugate moxetumomab pasudotox-tdfk in patients with relapsed/refractory HCL (59:10)
- Novel approaches under investigation for HCL (1:01:11)
- Case: A woman in her late 50s develops Richter’s transformation (RT) from CLL to diffuse large B-cell lymphoma (DLBCL) after receiving ibrutinib as second-line therapy (1:03:52)
- Pathogenesis and frequency of RT in patients with relapsed/refractory CLL (1:06:45)
- Comparison of the biology of Richter’s transformed versus de novo DLBCL; novel therapies under investigation for RT (1:10:06)
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