At the 65th ASH Annual Meeting in San Diego, California, Paolo Ghia, MD, PhD, Università Vita-Salute San Raffaele, Milan, Italy, discusses the importance of assessing minimal residual disease (MRD) and applying that assessment when treating patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), particularly for those with high-risk disease. 

Transcript:

Paolo Ghia: Hello, I'm Paolo Ghia from Università Vita-Salute San Raffaele in Milan, Italy. This year, in San Diego, at the [American Society of Hematology] (ASH) Congress, I presented the follow-up of the CAPTIVATE study. 

Oncology Learning Network: What advice do you have for fellow oncologists treating patients with chronic lymphocytic leukemia in the relapsed/refractory setting?

Paolo Ghia: Where the general trend of research or clinical [trials] is going these days is [teaching us] that we have to learn how to apply MRD assessment in clinical practice. So, we need clinical trials that are MRD-driven.

We had the impression that in the CAPTIVATE study, the level and the depth of response, including undetectable MRD, is really making a difference [particularly] in patients with high-risk disease, unmutated monoclonal genes, [and] p53 abnormalities. We believe that the personalization of the treatment based on MRD might improve the responses of our patients. 

In particular, we can, probably in the future, modulate the length of the treatment based on the level of undetectable MRD, so that some patients will need more than 1 year of the combination of ibrutinib plus venetoclax. Some patients [may] need less of that because they achieve earlier undetectable MRD. So, that's the challenge for the future.

Source: 

Ghia P, Wierda WG, Barr PM et al. Relapse after first-line fixed duration ibrutinib + venetoclax: high response rates to ibrutinib retreatment and absence of BTK mutations in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) with up to 5 years of follow-up in the phase 2 captivate study. Presented at the ASH 65th Annual Meeting & Exposition; December 9-12 2023; San Diego, California. Abstract 633