Introduction
CARE™ Hematology Faculty lead, Dr. Peter Anglin (Stronach Regional Cancer Centre, ON), connected virtually with international expert Dr. Stephan Stilgenbauer to discuss Considerations for treatment of two separate cases in frontline CLL.
Case 1 Typical
72 year-old patient is IgHV unmutated, no Del17p or TP53.
Case 2 – Atypical
58 year-old active/fit female, IgHV mutated with normal cytogenetics. Requires therapy.
(Refer to the notes below the video stream for timestamps that can be used to navigate video.)
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Case 1 – Typical [0:12-5:46]
72-year-old patient – lab report shows IgHV unmutated, no Del17p or TP53.
Details
Patient has hypertension, type 2 diabetes and is taking medication for same. A little overweight but active and lives 30 minutes from hospital. Has been monitored for 4 years.
Now has enlarged lymph nodes and hemoglobin of 106. Fatigued and generalized lymphadenopathy. CAT scan shows same. Creatinine clearance of 65 mL/min.
Key Discussion Points
- Initiate treatment excluding chemoimmunotherapy options
- Recent trials show dramatic superiority with non-chemoimmunotherapy treatment
- Consideration of continuous BTKi or fixed duration VEN+OBIN
- Details on options and discussion on patient preference
Variants on case
If patient is IgHV mutated or Del17p positive, how does that reframe discussion and therapy choices?
Case 2 – Atypical [5:33 – 8:15]
58 year-old active/fit female, IgHV mutated with normal cytogenetics. Requires therapy.
Key Discussion Points
- Think long-term response / long-term disease control potentially lasting decades
- Toxicity considerations and fixed duration treatment
Related Content
CARE™ Hematology Faculty lead, Dr. Peter Anglin (Stronach Regional Cancer Centre, ON), connected virtually with international expert Dr. John Seymour (Peter MacCallum Cancer Centre, Australia) earlier in summer to discuss how standards have evolved and considerations relevant to CLL treatment decisions in today’s landscape.
You can access this link by clicking here.
