There are 2 major ongoing trials. One is in fit, young patients with FCR against ibrutinib in combination with rituximab. The other trial is [in patients] older than 65, and it is BR against ibrutinib in combination with rituximab. We are all very excited about these novel agents because there's a chance that we can probably give the patients a good response, but at the same time we need to compare. These are currently therapies that we take indefinitely, for a long period of time. Whereas, in chemotherapy approaches, they are only upon a limited course. We are still trying to debate what is best in light of all these new agents at our disposition.
What are some of the advances you are excited about in CLL?
We are all very excited with the most recent FDA approval of venetoclax, a BCL-2 inhibitor, in combination with rituximab for all patients with CLL. We so much needed this new compound because it has proven to be efficacious after ibrutinib failure or idelalisib failure. Now, it's another option for our patients. Let's say if you had a patient with a recent surgery that was major, or atrial fibrillation. It would be very hard for you to manage that patient with ibrutinib because it could make the bleeding worse or the arrhythmia worse. Having venetoclax at your disposal really allows you to have more options of care.
Now, there's never been a head-to-head comparison between the 2, but we know that both have excellent clinical activity in the relapsed/refractory setting. They both have very good activity in 17p deletion. These are options of care for our patients, and you have to balance the clinical characteristics of the patient. If they have certain comorbidities that will make them more intolerant to 1 agent or the other, that is essentially how we are doing it in our practice.