CLL cannot be cured but there are several options when it comes to the initial treatment. According to Dr. Matthew Davids, associate director of the Center for CLL at Dana-Farber Cancer Institute, the standard treatment route will be some form of chemo-immunotherapy. Typically, a chemo-immunotherapy regimen is given as initial therapy for six months at a time. Any treatment lasting longer than six months is difficult to tolerate.
According to the National Comprehensive Cancer Network guidelines, ibrutinib (Imbruvica) and acalabrutinib (Calquence) with/without obinutuzumab (Gazyva) are the preferred first treatment for all previously untreated CLL patients.
Dr. Davids says for patients under age 65 with untreated IGHV-mutated, the go-to chemo-immunotherapy regimen is usually FCR–a combination of Fludarabine, Cyclophosphamide and Rituximab. Almost all patients will go into remission after this treatment, and about 50 percent of those patients will go into complete remission. Since this treatment route is an aggressive one, and isn’t well tolerated in older patients, doctors typically will not recommend it for patients over age 65.
For older patients, doctors may use a different chemo-immunotherapy treatment called BR, says Dr. Davids, which is often a combination of Bendamustine and Rituximab. For patients who may even be older or too frail for BR, another treatment option is combining the oral chemo drug chlorambucil with the CD20 antibody obinutuzumab.
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Dr. Matthew Davids is an Assistant Professor of Medicine at Harvard Medical School and the Associate Director of the Dana-Farber CLL Center. Read More
CLL cannot be cured but there are several options when it comes to the initial treatment. According to Dr. Matthew Davids, associate director of the Center for CLL at Dana-Farber Cancer Institute, the standard treatment route will be some form of chemo-immunotherapy. Typically, a chemo-immunotherapy regimen is given as initial therapy for six months at a time. Any treatment lasting longer than six months is difficult to tolerate.
According to the National Comprehensive Cancer Network guidelines, ibrutinib (Imbruvica) and acalabrutinib (Calquence) with/without obinutuzumab (Gazyva) are the preferred first treatment for all previously untreated CLL patients.
Read More Dr. Davids says for patients under age 65 with untreated IGHV-mutated, the go-to chemo-immunotherapy regimen is usually FCR–a combination of Fludarabine, Cyclophosphamide and
Rituximab. Almost all patients will go into remission after this treatment, and about 50 percent of those patients will go into complete remission. Since this treatment route is an aggressive one, and isn’t well tolerated in older patients, doctors typically will not recommend it for patients over age 65.
For older patients, doctors may use a different chemo-immunotherapy treatment called BR, says Dr. Davids, which is often a combination of Bendamustine and Rituximab. For patients who may even be older or too frail for BR, another treatment option is combining the oral chemo drug chlorambucil with the CD20 antibody obinutuzumab.
Learn more about SurvivorNet's rigorous medical review process.
Dr. Matthew Davids is an Assistant Professor of Medicine at Harvard Medical School and the Associate Director of the Dana-Farber CLL Center. Read More
