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IWWM-12 2024 | Treating WM in the frontline: current approaches and novel agents
Roman Hajek, MD, PhD, University of Ostrava, Ostrava, Czech Republic, speaks about selecting between available agents for the treatment of Waldenström’s macroglobulinemia (WM) in the frontline setting. He notes traditional therapies such as dexamethasone, rituximab, and cyclophosphamide (DRC), as well as the potential of newer targeted agents. This interview took place at the 12th International Workshop on Waldenström’s Macroglobulinemia (IWWM-12) in Prague, Czech Republic.
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Transcript
You know, it just depends on what is reimbursed or not in our country. Or if there are some clinical trials available, then we always try to enrol patients to clinical trials. So, answering the question, we are unfortunately very conservative. So, still use RCD or DRC as the first line usually. Ibrutinib is coming, but it’s still not approved, so we have to ask for permission, you know, insurance company on individual basis...
You know, it just depends on what is reimbursed or not in our country. Or if there are some clinical trials available, then we always try to enrol patients to clinical trials. So, answering the question, we are unfortunately very conservative. So, still use RCD or DRC as the first line usually. Ibrutinib is coming, but it’s still not approved, so we have to ask for permission, you know, insurance company on individual basis. So we are trying to do it and we are usually successful. There are a lot of new drugs, especially, you know, second, third, even maybe fourth generation of BTK inhibitors. Also coming the next generation of BCL2 inhibitors. So, you know, we still don’t know exactly how this new version of original drug will influence the prognosis of our patients. Some of them seem very promising. I personally do believe that we really need to do as we did in other diagnoses, adding BCL2 inhibitors. We significantly improve rate of complete remission or deepness of remission, for example in CLL, but also others. I think we have to follow this strategy also in Waldenstrom’s, despite its indolent disease. So I do believe we have to use this combination to achieve deep remission as usually achieved by current available drugs.
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