Are There New Approaches to CLL Watch and Wait?

Our recent CLL Global Research Foundation Town Hall featured CLL Global President, Dr. William Wierda, and Dr. Constantine Tam from Monash University in Melbourne. CLL patient advocate Jeff Folloder moderated the event. Watch the full webinar.

Transcript

Jeff Folloder:                          

Stephanie has a question that’s near and dear to my heart. When a CLL patient is first diagnosed, most of us are put into a program that the medical community calls watch and wait. The patients call it, watch and worry. Myself, I’m in my second pass with watch and wait. Stephanie wants to know, are there new approaches to watch and wait? Dr. Wierda, what do you think?

Dr. William Wierda:               

Well, no, there’s not new approaches to watch and wait necessarily. Watch and wait continues to be watch and wait. And we haven’t changed the iwCLL criteria for when to start treatment. We have a lot of new exciting agents that are very effective. I think that tends to make people want to move forward potentially earlier with starting treatment, but there’s no recommendation that’s come from anybody.

And I think the CLL community, and leadership in our community particularly, are still persistent with we need to treat when patients need treatment. There isn’t really any clinical benefit that we know of so far with early treatment. And so, for patients who don’t have active CLL, they’re better off being observed and monitored, and treatment be initiated when their disease is active, and when our aim is to get rid of the disease and get the patient in remission.

That’s always been a difficult conversation. It’s a little bit easier today, because our treatments are evolving very quickly. And we have new treatments, and new clinical trials, and research that’s ongoing. And so, my opinion is if you wait a year, you may have something better, some better treatment opportunity, in a year than you do today. We got great things today, but if you don’t really need it, you’re probably better off sitting tight, being patient, and waiting until you truly need treatment, and starting treatment at that time.