Second-Line Treatment for Chronic Lymphocytic Leukemia
- Chemotherapy. This treatment uses strong drugs to kill cancer cells all over your body. ...
- Monoclonal antibodies. Antibodies are immune system proteins that help your body find and kill cancer cells. ...
- Targeted drugs. ...
- Stem cell transplant. ...
- Treating minimal residual disease. ...
- Clinical trials. ...
- Takeaway. ...
What are second-line therapies?
Second-line therapies are those tried when the first ones do not work adequately. The management of a cancer case requires regular evaluation of treatment and adjustment as needed. A break with the primary treatment and an adoption of a new regimen signals “second-line treatment.”
What is the second line of treatment for cancer?
Overview of Second-Line Treatment for Cancer. Second-line treatment is treatment for a disease or condition after the initial treatment ( first-line treatment) has failed. Second-line treatment may be used for a few different reasons: The first-line treatment doesn't work The first-line treatment worked but has since stopped working.
What makes a drug second-line?
What makes a drug second-line? These are your medicines that are less commonly prescribed for a particular disease. But, they are available as options when first-line treatments alone are not working. What classifies a medicine as the second line?
What are second line drugs for TB?
Second line drugs are the TB drugs that are used for the treatment of drug resistant TB.
What is a second-line medication?
Any therapeutic agent that is not the drug of choice, or the 1st normally used to treat a particular condition; in rheumatoid arthritis, 2nd-line agents are used when standard 'first-line' therapy–ie, anti-inflammatory agents and corticosteroids fail.
What is the difference between first and second-line treatment?
Second-line treatment is treatment for a disease or condition after the initial treatment (first-line treatment) has failed, stopped working, or has side effects that aren't tolerated. It's important to understand "lines of treatment" and how they differ from first line treatment and can play a role in clinical trials.
What is 3rd line treatment?
Treatment that is given when both initial treatment (first-line therapy) and subsequent treatment (second-line therapy) don't work, or stop working.
What does line of treatment mean?
The first treatment given for a disease. It is often part of a standard set of treatments, such as surgery followed by chemotherapy and radiation.
Is Second-Line chemo Effective?
Second-line treatment often works very well for certain types of cancer. People with other types of cancer may have only a small chance that second-line treatment will work. Other factors that affect whether second-line therapy may work include: The stage of the cancer.
What is a second-line antibiotic?
Antibiotics were classified as “first-line” (amoxicillin, TMP-SMX, or erythromycin) or “second-line” (clarithromycin, azithromycin, amoxicillin-clavulanate, cephalosporin, or fluoroquinolone).
What is palliative chemotherapy?
Clarification regarding the term palliative chemotherapy is critical: palliative chemotherapy is defined as chemotherapy that is given in the non-curative setting to optimize symptom control, improve quality of life (QoL) and, ideally, to improve survival.
How effective is third line chemotherapy?
The median survival was 23 months (95% CI, 20.9–25.1) in patients treated with more than third-line chemotherapy, compared to 7 months (95% CI, 4.7–9.3) in patients treated with less than second-line chemotherapy (Fig.
What are third line drugs?
Third line therapy is usually defined as a regimen for an individual who has developed resistance to at least one drug in all three classes of anti-HIV therapies [nucleoside analogue reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors] or has failed ...
What happens after 2nd chemo treatment?
Nausea, vomiting, and taste changes You may experience nausea (feeling like you might throw up) and vomiting (throwing up) after your last chemotherapy treatment. It should go away in 2 to 3 weeks. Your appetite may continue to be affected due to taste changes you may have experienced during your treatment.
Is second round of chemo worse than first?
Overall, my second round of chemo went much better than the first... thanks to an adjustment Dr. Soule made based on my round one experience (she extended my steroid to be taken for three days after chemo, instead of just one, though with smaller doses on each day).
Is chemo worse the second time around?
The effects of chemo are cumulative. They get worse with each cycle. My doctors warned me: Each infusion will get harder. Each cycle, expect to feel weaker.
What is clinical trial?
Clinical trials are studies that test out new drugs or combinations of drugs. These new treatments may work better for you than the ones currently available. Ask the doctor who treats your CLL if a clinical trial might be right for you.
What is the treatment for lymphocytic leukemia?
Chronic lymphocytic leukemia (CLL) treatment often starts with chemotherapy, a monoclonal antibody, or a targeted drug. The goal of these treatments is to put you into remission, meaning you no longer have any signs of cancer in your body. Sometimes the first drug you try doesn’t work, or your cancer comes back after the treatment.
What to do if CLL doesn't work?
Takeaway. If the first treatment you get for CLL doesn’t work or stops working, your doctor will try a second-line therapy. Chemotherapy, monoclonal antibodies, and targeted therapies are all used as secondary treatments for CLL, either alone or in combinations. You may need to try out a few different treatments to find one that works for you.
Can you get cancer back after a second line?
Sometimes the first drug you try doesn’t work, or your cancer comes back after the treatment . If that happens, your doctor can try new drugs or combinations of drugs. This is called second-line treatment. It may work better than the first therapy you tried.
What is second line therapy?
Second-line therapies are those tried when the first ones do not work adequately. The management of a cancer case requires regular evaluation of treatment and adjustment as needed. A break with the primary treatment and an adoption of a new regimen signals “second-line treatment.”.
What is the first line of treatment?
First line therapy is the treatment regimen or regimens that are generally accepted by the medical establishment for initial treatment of a given type and stage of cancer. It is also called primary treatment or therapy. The intent of first-line therapy is to cure the cancer if possible. Also called induction therapy, this primary therapy is the first assault of chemotherapy drugs on the malignancy.
What is the intent of first line therapy?
The intent of first-line therapy is to cure the cancer if possible. Also called induction therapy, this primary therapy is the first assault of chemotherapy drugs on the malignancy.
Is salvage therapy considered third line therapy?
The terms “third-line therapy ” and even “fourth-line therapy” are occasionally used for subsequent treatment, but salvage therapy is also used. Written guidelines rarely specify anything beyond second-line therapy. The same treatments can be used for subsequent treatment.
Can a first line therapy be approved for second line therapy?
Sometimes first-line therapies show progress for a period of time followed by a stalling or continued growth of the cancer. Often the FDA will specifically approve a new drug for second-line therapy. This labeling is common for new drugs that treat cancers which already have accepted treatments.
Is there a law on first line therapy?
There is no law, or even a community of practice rule, that doctors must use the accepted first-line therapy for a patient, ...
Is there a law that states that doctors must use first line therapy?
There is no law, or even a community of practice rule, that doctors must use the accepted first-line therapy for a patient, although when they do they “cover their backsides” to some extent and reduce their exposure to malpractice suits. Second-line therapies are those tried when the first ones do not work adequately.
What are the second line drugs?
Second line drugs are the TB drugs that are used for the treatment of drug resistant TB. The second line drugs include levofloxacin, moxifloxacin, bedaquiline, delamanid and linezolid. There is also pretomanid which is a new second line drug recommended in 2019 for the treatment of drug resistant TB.
What is the second line of treatment for drug resistant TB?
Second line drugs for treatment of drug resistant TB (as of March 2019) WHO now recommends that all oral regimens should become the preferred option for most patients. It is a major step forward in the treatment of patients with drug resistant TB that most patients will no longer be required to have injectable drugs.
What is the second line of Amikacin?
Amikacin, a second line injectable drug. In 2019 WHO published new consolidated guidance on the second line drugs to be used for the treatment of drug resistant TB. 2"WHO consolidated guidelines on drug-resistant tuberculosis treatment", 2019, Geneva, https://www.who.int/tb/publications/2019/consolidated-guidelines-drug-resistant-TB-treatment/en/ ...
Should second line drugs be used under supervision?
All the second line drugs should only be used under the supervision of an experienced doctor. Their use needs to take into account not only the World Health Organisation (WHO) recommendations, but also what is recommended by a country's National Treatment Program. 1Emanuele Pontali et al, "Regimens to treat multidrug-resistant tuberculosis: past, present and future perspectives", 2019, European Respiratory review, https://err.ersjournals.com/content/28/152/190035#ref-32
What causes a drug to change first-line or second-line status?
Or what causes first-line medicines to become the second-line? What causes second-line drugs to become first-line ? Once again, I’m going to make an educated guess here.
What makes a drug first line?
What makes a drug first-line? These are the medicines doctors first resort to for a given disease (the doctors first choice try). They are the most commonly prescribed medicines for a particular disease. These medicines are well accepted by the medical community. For asthma, they include systemic corticosteroids like Flovent, Asmanex, and Qvar.
Is corticosteroids a first line treatment for COPD?
So, it remains a first-line treatment for COPD. Likewise, because it may help some asthmatics, it remains a second-line option here. Researchers learn more. Back in the 1970s, doctors were leary that inhaled corticosteroids (ICS) may cause the same side effects as systemic corticosteroids.
Is Atrovent a first line asthma medicine?
Atrovent was once-upon-a-time considered a first-line asthma medicine. It fit all the qualifications of one. But, subsequent studies did not show it benefited most asthmatics. Studies do show, however, that it does help most COPDers. So, it remains a first-line treatment for COPD.
What is the first line of therapy?
You know, the first line of therapy is just the first treatment that you end up getting. Now, traditionally, again, that’s been the best treatment that we’ve had, the ones that have had the most effectiveness in terms of shrinking cancer cells and in terms of improving survival.
Is patient power a substitute for medical advice?
Our discussions are not a substitute for seeking medical advice or care from your own doctor. That’s how you’ll get care that’s most appropriate for you.
Is a second line better than a third line?
So that second line is just the second treatment you get. There are lines in the third treatment that you get. But, of course, there are patients who get second-line and third-line treatments that are better than their first-line treatments sometimes. A great example of this would be targeted therapy where, a patient may not have time ...
Lines of Treatment
The Option of Clinical Trials
- Understanding line of treatment becomes very important when looking at clinical trialsfor cancer. Some clinical trials require that people have no previous treatments, whereas others are designed for people who have had inadequate results with a previous treatment. For example, one clinical trial may require the treatment to be used as a first line therapy, whereas another may only be en…
Questions to Ask About Second-Line Treatments
- Since the failure of a first treatment can leave you feeling overwhelmed and anxious, having a list of questions to ask your healthcare provider (as well as a friend to attend the visit with you) can be very helpful. 1. How effective is the second-line treatment, and how does it compare to the treatment you had previously? 2. What are the possible side effects of the treatment? 3. What ha…
Example
- An example of the importance of defining lines of treatment is a 2019 study that compared different second-line treatments for lung cancer. Since there are a number of different options, and many studies look at the effectiveness of first line therapies, this can give important information to oncologists. For example, the second line chemotherapy drug Taxotere (docetax…
Coping
- Thinking about and making decisions about second-line treatment can be heartwrenching. It's hard enough the first time around, but at this point many people are exhausted and it's easy to get discouraged. Reach out to people in your support network, and don't be afraid to share your fears. Certainly, not every friend will be comfortable with this, but choose at least a friend or two with …