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ERIC 2020 | Treating CLL patients with Richter transformation

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Barbara Eichhorst

Barbara Eichhorst, MD, University Hospital Cologne, Cologne, Germany, discusses Richter’s transformation in chronic lymphocytic leukemia (CLL). Richter transformation is defined as the development of aggressive lymphoma in patients with CLL. There are no other treatment options other than conventional chemoimmunotherapy or allogeneic stem cell transplantation, therefore the prognosis is extremely poor. Dr Eichhorst then discusses the Phase II CLL-RT1 (NCT04271956) trial evaluating zanubrutinib plus tislelizumab as a treatment for patients with Richter transformation. This interview took place during the European Research Initiative on CLL (ERIC) International Virtual Meeting 2020.

Transcript (edited for clarity)

We have recently done a meta-analysis on the incidence rate of Richter transformation across different trials from the German CLL study group and we observed that of what is not surprising, but at least in the era where we still not have other treatment regimen than conventional chemoimmunotherapy or also allogeneic stem cell transplantation that the prognosis in those patients is really very poor...

We have recently done a meta-analysis on the incidence rate of Richter transformation across different trials from the German CLL study group and we observed that of what is not surprising, but at least in the era where we still not have other treatment regimen than conventional chemoimmunotherapy or also allogeneic stem cell transplantation that the prognosis in those patients is really very poor. And therefore, there was an urgent need for those patients.

We started in Germany together with colleagues in Austria and in Denmark, a phase two trial evaluating a combination of a new checkpoint inhibitor, tislelizumab in combination with the BTK inhibitors zanubrutinib. And here we have included so far eight patients and the first patients are now for more than six months on treatment. And we see some responses continuing now for six months, but we also had the first patients who entered the study seven months ago unfortunately died due to his Richter transformation. So what we are looking for is can we have different treatment options than just chemoimmunotherapy, because it’s problematic to treat these elderly patients once they have been transformed. And therefore we are evaluating this combination with checkpoint inhibitor plus BTK inhibitors.

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