CLL Treatment Considerations
- CLL treatment is shifting towards personalized therapies and moving away from standard chemotherapy.
- Targeted therapies and monoclonal antibodies are two new forms of “personalized medicine” that focus on attacking the cancer while sparing healthy tissue.
- Personalized medicine in CLL has led to better disease control, fewer side effects, and improved quality of life for patients.
- Speak with your doctor about what treatment works best for you based on your diagnosis and treatment goals, including financial considerations.
Personalized therapies are helping to move away from the “one size fits all” chemotherapy approach. Instead, the focus has shifted towards treatments that are tailored to each individual patient’s diagnosis and needs.
Read MoreWhat are the personalized medicines for CLL?
“This transition towards personalized medicine marks a pivotal moment in CLL treatment, promising a future where therapy is tailored to the individual needs and genetic makeup of each patient.
Here’s a brief overview of what doctors now have to offer CLL patients.
- Advancements in Targeted Therapies: Targeted therapies focus on specific proteins and signaling pathways in CLL cells, effectively blocking their growth and survival mechanisms.
- Introduction of Monoclonal Antibodies: Among the first targeted therapies, these mimic the immune system by attaching to specific proteins on the surface of cancer cells. Often combined with other treatments for better outcomes.
- Innovations with BTK Inhibitors and Venetoclax: These directly target critical survival pathways of CLL cells. Venetoclax, for example, targets the BCL-2 protein that helps CLL cells survive, triggering rapid cell death and effective disease control.
Dr. Choi underscores the significance of these advancements. The shift to personalized medicine in CLL has improved outcomes for patients, with fewer side effects and better quality of life.
“These drugs [are] proving to be really effective and sparing patients from the general side effects of older chemotherapy drugs,” he says.
Related: New Drugs for CLL Treatment
How has personalized treatment helped patients?
CLL is a blood cancer that often affects older adults.
Its slow-growing nature makes CLL an ideal candidate for personalized medicine, because it allows time to create a treatment plan that is right for each individual’s specific disease characteristics, Dr. Choi explains.
“With these targeted therapies, we’re not just treating CLL – we’re fundamentally changing the way we think about and manage the disease,” Dr. Choi says. “It’s about precision and personalization, ensuring each patient receives the most effective and least disruptive treatment possible.”
Choi says this shift from broad-stroke chemotherapy has some key advantages for patients:
- Precision: Targeted therapies attack specific molecules within CLL cells, sparing healthy cells. Better results, fewer side effects.
- Effectiveness: These therapies have shown to control the disease better by depriving CLL cells of signals needed to grow, divide, and survive, leading to better disease management and remission rates.
- Fewer side effects: Patients experience fewer traditional chemotherapy side effects like hair loss, low blood cell counts, and severe infections.
- Innovation: Ongoing research continues to introduce new, more effective treatments.
Related: What are BTK Inhibitors?
How can I best partner with my doctor on treatment?
With all of the new choices in CLL treatment, talking to your doctor is more important than ever. Understanding exactly what your diagnosis means plus the pros and cons of each treatment option can make all the difference to your experience.
Shared decision-making between doctor and patient ensures that CLL treatment is not just about managing the disease effectively. It is also about respecting your wishes and taking into account your lifestyle, preferences, and values.
Topics to discuss with your doctor:
- Preferences: Such as the desire to minimize certain side effects or considerations regarding treatment frequency and duration.
- Flexibility and Options: Having a variety of options helps personalize treatment plans that align with your needs and preferences.
Treatment Administration: You may have a choice between taking a pill or receiving medication intravenously. - Side Effects: Understand which treatments increase or avoid the risk of particular side effects.
- Monitoring: The need for regular monitoring and hospital visits can influence treatment choices, with some patients preferring regimens that require less frequent check-ups.
- Duration: Some patients may opt for finite therapy durations to avoid long-term treatment, even if it means more intensive initial therapy.
- Expectations and outcomes: What treatment results can I expect? And how long will they last?
“We want to partner with our patients and decide together what the best thing for you will be… it’s oftentimes centered on your preferences… all of those factors are things to discuss with your physician so that you can decide together what the best approach will be,” Dr. Choi says.
What do the new CLL treatments cost?
Costs are a very important consideration in CLL treatment.
As therapies evolve, so do costs. This can present challenges.
“Understanding the financial implications of your treatment options is as crucial as understanding the medical aspects,” Dr. Choi says. “It’s essential to explore all available resources, from insurance coverage to assistance programs, to ensure that financial barriers do not impede access to the best possible care.”
Some very important considerations about treatment expenses:
- Targeted therapies and monoclonal antibodies can be significantly more expensive than traditional chemotherapy, reflecting the advanced research and development behind these drugs.
- Insurance coverage for new CLL treatments vary widely among providers, with some treatments fully covered and others requiring substantial co-pays or meeting specific criteria before coverage approval.
- Many pharmaceutical companies offer assistance programs to help offset the costs of new treatments, providing financial relief to eligible patients.
- Numerous foundations and charities provide grants and financial assistance specifically for CLL patients, helping to bridge the gap between treatment costs and insurance coverage.
Dr. Choi advises patients to have open conversations with their healthcare team about the costs associated with their treatment plan. They can help you navigate all of the possibilities to ensure you get the best care at an affordable price.
Dr. James Gerson explains how BTK inhibitors work
What’s the future of CLL treatment?
The landscape of CLL treatment continues to evolve rapidly. Hopeful therapies in clinical trials are paving the way for even more effective and personalized approaches.
- CAR T-Cell Therapy: A cutting-edge approach that genetically engineers a patient’s own immune cells to better target and kill CLL cells. This therapy has shown remarkable results in other types of cancer and is now being explored for its potential in CLL.
- Novel Drug Combinations: Research into combining different targeted therapies to improve outcomes and potentially reduce the risk of resistance. By combining drugs that act on different pathways or mechanisms within the cancer cell, it’s possible to enhance efficacy and potentially overcome resistance to single-agent treatments.
- Precision Medicine: The ongoing development of treatments tailored to the specific genetic and molecular characteristics of a patient’s CLL, aiming for maximum efficacy with minimal side effects.
“The horizon of CLL treatment is expanding with the advent of CAR T-cell therapy and innovative drug combinations,” Dr. Choi says.“ These approaches not only promise to enhance the effectiveness of treatment but also offer a glimpse into a future where CLL can be managed even more precisely and with greater success,” he adds.
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