Carsten Niemann, MD, PhD, Copenhagen University Hospital, Copenhagen, Denmark, describes using minimal residual disease (MRD) monitoring in treating chronic lymphocytic leukemia (CLL). Measuring MRD levels can enable accurate assessment of patients responses to treatment and can accordingly adjust treatment levels. MRD monitoring can additionally predict outcomes to chemoimmunotherapy and certain targeted therapies and Dr Niemann emphasizes the need to create MRD-guided regiments as in the Phase II HOVON-141/VISION trial (NCT03226301). This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Carsten Niemann, MD, PhD, Copenhagen University Hospital, Copenhagen, Denmark, gives an overview of the Phase III GAIA trial (NCT02950051), which assessed standard chemoimmunotherapy versus a combination of rituximab, venetoclax, obinutuzumab, and ibrutinib in patients with chronic lymphocytic leukemia (CLL). Patients received either standard chemoimmunotherapy, rituximab with venetoclax, obinutuzumab with venetoclax, or obinutuzumab with ibrutinib and venetoclax. Rituximab or obinutuzumab with venetoclax were associated with higher rates of undetectable minimal residual disease (uMRD), and whilst addition of ibrutinib added further benefit to patients, more adverse events were reported. Further research is required to identify patient subgroups who will benefit from chemoimmunotherapy the most. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Jacqueline Barrientos, MD, MS, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, presents findings from an analysis of the informCLL Real-World Registry, which enrolled patients with chronic lymphocytic leukemia (CLL). Patient care was compared with current National Comprehensive Cancer Network (NCCN) Guidelines. Detection of 17p and TP53 mutations were found to be inadequate in the cohort, which resulted in the aforementioned patients erroneously receiving chemoimmunotherapy. Dr Barrientos highlights the importance of testing for mutations, as well as the use of targeted therapies such as ibrutinib and acalabrutinib. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.
Robin Foà, MD, Sapienza University of Rome, Rome, Italy, discusses the use of measurable residual disease (MRD) monitoring in chronic lymphocytic leukemia (CLL), comparing it to its role in indolent non-Hodgkin lymphoma (NHL). In recent years, new treatment modalities have enabled a large number of patients with CLL to achieve MRD negativity. Despite its common use in clinical trials, MRD negativity is currently not used in daily clinical practice, nor as a treatment endpoint in CLL in contrast to other hematological malignancies. With a majority of patients with CLL initiating therapy at an older age, MRD monitoring has not yet been implemented in clinical practice. Prof. Foà additionally discusses the relevance of chemoimmunotherapy in the context of new effective therapies for CLL. This interview took place at the 63rd ASH Annual Meeting and Exposition congress in Atlanta, GA.