The Impact of the CLL Global Research Foundation | Understanding CLL Remission

Dr. Philip Thompson discusses his early research supported by the CLL Global Research Foundation, which has helped to understand long-term remission in CLL. Dr. Thompson’s research revealed that some patients treated with FCR therapy achieved prolonged remissions and helped to identify genomic traits linked to long-term survival.

Transcript

Dr. Philip Thompson:

So one of the key observations that I made actually when I was right towards the end of my fellowship in 2015 was we had this group of patients that had been treated with FCR, which was the regimen that Michael had developed with Bill Plunkett, that there were quite a number of patients that were in these hugely long-term remissions and were potentially cured of their disease. And this was an observation that had never been made before. It was always felt that CLL is an incurable disease. And so this was an important observation, and we also defined the specific genomic characteristics that were associated with that, which was the mutated IGHV.

And then we then went on to do a number of studies following that initial publication, which was published in 2016. We had stored samples from a subsequent study, and we got funding from CLL Global to do next generation sequencing with a new type of MRD analysis. And that allowed us to detect that many of those patients actually still had very low-level disease in the blood and in the bone marrow and we published that in Blood in 2019.

And then we wanted to take that a step further. So we had originally published the paper in 2015 showing these long-term responders. And then in 2022, I thought, “Well, time, we updated this analysis.” So we got some funding from Global to try and update those clinical outcomes. And actually, I spent a lot of time myself on the phone to these patients. It was quite fun. We wanted to do two things’ we wanted to find out, A, where people were still alive and doing well, and then B, if they hadn’t had disease progression, we wanted to be able to collect samples from them to see if they had no detectable disease or whether they maybe had a little bit of detectable disease that was remaining stable. So the plan was to sequence them and sequence them serially so that we could see if they had disease and if it was stable or not.

But the actual clinical part of it we published in 2023 in Blood showing that we had a median progression-free survival of just under 15 years for the mutated IJHV group, and there were patients way out beyond 20 years still in remission. And it was really fun calling these patients and they all said, “How is Michael? Please tell him how grateful I am that I’m still here 22 years later. I’m well. I couldn’t be more thankful.” I remember one lady who was really sharp and she was in her well into her 90s, and I said to her, “Okay, well, I’m glad you’re still doing well, and what do you think about doing this study where we get some blood from you once a year for five years?” And she said, “Sure, I’ll sign up for it.” She said, “But I don’t know if I’ve got five years.”

I think one of the privileges of being a clinical researcher is that, yes, you get to think about the science and think about how can we better impact the disease? But then you also get that human element, and I just think a great privilege of being a clinical researcher is getting to see firsthand the impact that the scientific side is making on the person.