If you could, briefly give me an overview of the first-generation BTK (Bruton tyrosine kinase) inhibitor ibrutinib in terms of its indication in CLL. Could you ...
We did recently see longer-term follow-up published on the iLLUMINATE study, which continues to look very good for ibrutinib/obinutuzumab, but as we compare it across to other frontline datasets for ibrutinib monotherapy, I don't think there are clear differences that have emerged there. Can you comment on updated results for the ibrutinib plus obinutuzumab combination not only in the relapsed/refractory setting, but in the front-line [setting as well]. Do you think this combination has a future in our practices? But ibrutinib has also been combined with obinutuzumab, and maybe the Achilles' Heel of that trial was that there was no ibrutinib monotherapy to demonstrate the contribution of effect. In the relapsed setting, the progression-free survival (PFS) of course is a bit shorter. Of course, it is the BTK inhibitor with the longest track record in CLL. Paul Barr recently published up to 8 years of follow-up from ibrutinib [in] the frontline setting where we see 59% of patients are still progression-free at around the 7-year mark. Anthony R. Mato, MD, MSCE: Now we're going to switch gears to Chronic Lymphocytic Leukemia (CLL). I want to start with Callie. We've been saving you now for the CLL section because you have a lot to say.
Researchers report that half of the online pharmacies are rogue operations that may operate without a license or have other serious shortcomings.
Healthcare providers need to be aware that many of these rogue and unapproved pharmacies do not even require a prescription or have access to pharmacist consultations, putting patients at high risk for adverse drug events.” “This is a significant concern for patient safety,” Ozawa said. “Online access to treatment for CML is a significant concern if medicines are dispensed without a prescription or proper clinical oversight,” Ozawa wrote. Half (52%)were classified as “rogue” pharmacies that might operate without a license, sell counterfeit or expired products, stealpayment information, or reject important safety precautions, such as requiring a prescription for potentially hazardous medications, the researchers found. As a result, more CML patients are turning to online pharmacies. That increased out-of-pocket payments for some U.S. patients taking generic imatinib; many pay as much as $700 monthly at brick-and-mortar pharmacies.