Expert Advises Patients with CLL on Three Things They Should Be Aware of To Maximize the Benefit of Upfront Treatment
In an interview with CURE®, Dr. Mazyar Shadman discussed ways that patients with chronic lymphocytic leukemia can play a role in ensuring that they are able to reap the benefits of treatment.
BY Ryan McDonald and Dr. Mazyar Shadman
PUBLISHED June 29, 2020
Patients with chronic lymphocytic leukemia must remain observant and report any side effects, especially if they are serious, to ensure that they get the most out of their upfront treatment, according to Dr. Mazyar Shadman.
In an interview with CURE®, Shadman, of Seattle Cancer Care Alliance and Fred Hutchinson Cancer Center, discussed ways that patients can play a role in ensuring that they are able to reap the benefits of treatment.
First of all, they need to be well educated about the potential side effects of this treatment. So, some side effects are more serious. And they need to know that if that happens, they need to call the physician or the team as soon as possible. For example, if you're on a Bruton tyrosine kinase inhibitor, and you know (there’s) bleeding, you need to notify your physician. So, just be aware of side effects and know that some of them are more urgent and others are not, but make sure you are in communication with your team.
These days, we have a lot of options we can (use), using BTK inhibitors as an example, we have now next generation BTK inhibitors that are basically better tolerated so we can always switch treatment to one of the novel ones or maybe even change the class to a completely different type of therapy.
Number one would be knowing the side effects. Number two (is) just knowing what to expect, again, a lot of times, it's not uncommon for patients who; we do get a lot of the second opinions and consults. And they just didn't know that this treatment, for example, is not supposed to be stopped. They're like, ‘Oh, I'm taking a nap for a year.’ So, give a realistic expectation to the patient on what to expect from a drug like ibrutinib or acalabrutinib … or duvelisib if you're in the relapsed setting. Also, with venetoclax, just give the realistic expectation (that) yes, we do give the treatment for one year, but I can't promise that at the end of one year, if I stop, you'll be in remission for years, right? It depends on how good (you respond) to the treatment. So, number two would be giving realistic expectations (and) number three … goes back to this principle of a doctor-patient relationship and we have to come up with a plan that both are comfortable with. Some patients just feel safer to be watched a little bit more closely and some don't.