F treatments

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Folks - read this one from Dr. Furman very careful - I cannot think of a better summary.......

This study, comparing FC versus FCR represents important "issues" with the systems in place governing:1. determination of the "standard of care"2. FDA approval3. insurance willingness to cover a treatmentFC versus FCR has no impact on the care provided in the United States. It will possible lead to a dramatic increase in the use of Rituximab in Europe, where most patients do not automatically receive Rituximab.It may also provide data that will be used to obtain FDA approval for FCR, obligating insurers to pay for the Rituximab. But this last one is not much of an issue as most insurers will cover the Rituximab.Not everyone in the US uses FCR as many still use FR. While FCR demonstrates improved response rates compared to FR, no has demonstrated improved survival, which is the more important measure. It is important to remember the more toxic therapy might yield better responses, but leave patients unable to tolerate much else afterwards.My personal belief is to make CLL as chronic of a disease as possible. More important than obtaining a response is keeping the patient symptom free and able to live life with the highest quality of life as possible.There are several studies looking at FCR versus FR, the largest is a cooperative group trial, but these results will not be available for a very long time. Overall, the information from ASH was fairly uninteresting. The other large study presented compared PCR to FCR. This study used lower doses of Fludarabine than almost what everyone else uses. The study demonstrated no difference in toxicities or outcomes. But its applicability is certainly limited.Rick Furman, MDA Good Credit Score is 700 or Above. See yours in just 2 easy steps!