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Alert Number 14

Hitting a Home Run with Campath Consolidation?

Date: April 18, 2004

Changing Landscape, Heightened Expectations

The conventional wisdom used to be that CLL is an incurable disease and that there is no point in trying to mop up the last remaining cancer cell in the patient's body. How things have changed in the last few years! If a patient is in CR remission after therapy but still has some cancer left behind, should we treat the patient again almost right away while he is still in remission, to try and get rid of the last bit of the cancer? This is the hot new frontier of CLL clinical trials. Many researchers are tacking a "consolidation" phase at the tail end of a full-fledged therapy regime, to see if the one-two punch can take the tumor kill all the way to completion. The popular RPC combo trial from the ECOG study group (Ohio State and other locations) has added a Campath chaser after full-course RPC therapy.

But what about the downsides? Trust me, there are always downsides to consider - there is no free lunch in the cancer business. The latest article on our website discusses the potential downsides of Campath consolidation therapy following quickly upon the heels of primary therapy with conventional chemotherapy. We review and discuss the details of two pivotal clinical trials reports that have just been published in the last couple of months. The results from both trials are sobering and may give you cause for concern. Once again, it becomes very clear that CLL patients need to make risk-adapted, individualized, prognostic-based therapy decisions. In this game, it is what you do not know that will come back to bite you.

Be well, stay informed.


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