Dr. Pinilla-Ibarz on the Role of Chemotherapy in CLL

Javier A. Pinilla-Ibarz, MD, PhD, senior member, Moffitt Cancer Center, discusses the role of chemotherapy in patients with chronic lymphocytic leukemia (CLL).

There is no doubt that chemotherapy is beginning to fade in the treatment paradigm, says Pinilla-Ibarz. At the 2018 ASH Annual Meeting, physicians are expecting to hear the data on the ALLIANCE study, which is comparing single-agent ibrutinib (Imbruvica) with the combination of ibrutinib, rituximab (Rituxan) and bendamustine (Treanda) in the frontline setting, says Pinilla-Ibarz.

At this point, most of the guidelines recommend chemotherapy in the form of fludarabine-cyclophosphamide-rituximab (FCR) for patients age 65 or younger who have IGHV-mutated surface immunoglobulin. Data in this patient population show long-term benefit and evidence of possible cure with this regimen, says Pinilla-Ibarz. Bendamustine plus rituximab is still an option for these older patients, but Pinilla-Ibarz says patients should be counseled on an individualized basis to determine what regimen to pursue.