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Expert Explains Next Steps With Advancing CLL Care

Danielle Bucco
Published: Tuesday, May 23, 2017

Richard R. Furman, MD

Richard R. Furman, MD

The FDA approval of agents such as ibrutinib (Imbruvica), venetoclax (Venclexta), and obinutuzumab (Gazyva), offers flexibility in choosing the best therapy for a patient with chronic lymphocytic leukemia (CLL), according to Richard R. Furman, MD.

State of the Science Summit on Hematologic Malignancies. In an interview, Furman discussed the continued evolution of the field of CLL and how physicians decide on the optimal treatment sequence for their patients.

OncLive: Can you start by providing an overview of your presentation on CLL?

Furman: I took what I believe to be a slightly unique approach and discussed how we should be using risk assessment in the era of novel agents. The goal is that our prognostic markers are no longer prognostic. In a way, that’s good because everyone seems to respond to novel therapies. The question then becomes how long will they see a response for.

The hope is that we can identify those patients who might need more than just a BTK inhibitor or a BCR antagonist. Those patients may have an increased risk of developing Richter’s transformation, and [so we could] possibly come up with the means for intervening [with] them differently, which might enable them to enjoy long-term positive outcomes. 

What are some of the most exciting agents moving through the pipeline right now in CLL?

The 3 most exciting and important agents that we have for the care of our patients include ibrutinib, venetoclax, and obinutuzumab. These 3 agents afford a great deal of flexibility in choosing the best therapy for a patient and inducing dramatic responses. Although ibrutinib is well tolerated most of time, there are a few patients who have contraindications to it, mainly patients who have bleeding risks or atrial fibrillation. For those patients, venetoclax and obinutuzumab offer great alternatives.
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