BSH 2022 | The importance of genomic testing when making treatment decisions in CLL
Barbara Eichhorst, MD, University Hospital Cologne, Cologne, Germany, discusses the importance of genomic testing in patients with chronic lymphocytic leukemia (CLL). Dr Eichhorst explains that genomic testing is extremely important for detecting TP53 mutation and other genetic aberrations, such as immunoglobin heavy chain gene (IgHV) subtypes, as they may influence response and duration of remission to targeted agents. Dr Eichhorst also explains that patients with high-risk cytogenetics should be monitored closely, and it is important to incorporate genomic testing when considering time-limited or continuous treatment plans for patients. This interview took place at the 62nd Annual Scientific Meeting of the British Society for Haematology (BSH) 2022, in Manchester, UK.
Transcript (edited for clarity)
That’s a very important question, because when we look at the US, we see there that there is less genomic testing being done on our patients because the argument is, “Oh, I’m going to start a BTK inhibitor to my patient anyhow”.
I still would like to encourage all physicians to do genetic testing because it’s particularly important in young and fit patients because there, we know that even with the targeted agents, TP53 mutation or other genetic aberrations as IgHV status subtypes, for example, or maybe also as a SF3B1 mutation are predicting a shorter remission duration even to the targeted agents...
That’s a very important question, because when we look at the US, we see there that there is less genomic testing being done on our patients because the argument is, “Oh, I’m going to start a BTK inhibitor to my patient anyhow”.
I still would like to encourage all physicians to do genetic testing because it’s particularly important in young and fit patients because there, we know that even with the targeted agents, TP53 mutation or other genetic aberrations as IgHV status subtypes, for example, or maybe also as a SF3B1 mutation are predicting a shorter remission duration even to the targeted agents.
And therefore, it’s important that on the one hand, we follow those patients very closely, we consider inclusion in clinical trials where we may be able to offer even more combination therapies, being able to control this high-risk disease even better, or even still considering allogeneic stem cell transplantation or other cellular therapies, if available. Therefore, it’s still important. And even for elderly, less fit patients, this information with respect to the choice of treatment, if you would prefer time-limited treatment, where in my opinion, particularly in patients with favorable prognostic profile, benefit a lot in contrast to the continuous treatment will help in the treatment decision.
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Disclosures
I receive honoraria for presentations and advisory board from several different pharmaceutical companies involved in targeted agents in CLL (Abbvie, BeiGene, BMS, Gilead, Janssen, MSD, Roche).
