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R. Gregory Bociek, MD, discusses the evolving role of chemoimmunotherapy in chronic lymphocytic leukemia.
R. Gregory Bociek, MD, associate professor of internal medicine, Division of Oncology and Hematology, program director, Hematology/Oncology Fellowship Program, University of Nebraska Medical Center, discusses the evolving role of chemoimmunotherapy in chronic lymphocytic leukemia (CLL).
Some patients with CLL require immediate therapeutic intervention for symptoms or rapidly progressing disease, whereas others can remain on active surveillance for decades, explains Bociek. Currently, the role of chemoimmunotherapy is diminishing among novel targeted options that confer improved survival vs chemoimmunotherapy.
However, young, fit patients with favorable genetics and a mutated phenotype could still be considered for chemoimmunotherapy, especially if they are interested in receiving a time-limited option, Bociek explains. A significant proportion of these patients could obtain a durable response for many years with a 6-month course of chemoimmunotherapy.
Additionally, treatment-related and financial toxicities associated with targeted therapies alone or in combination with monoclonal antibodies may prevent some patients from receiving these newer treatments, says Bociek. Moreover, although some newer time-limited targeted options exist, many of these options require continuous dosing, concludes Bociek.