Chronic Lymphocytic Leukemia

Panelists discuss how real-world evidence studies from databases like Flatiron demonstrate that second-generation Bruton tyrosine kinase (BTK) inhibitors perform better than first-generation agents in clinical practice, providing hypothesis-generating data that support clinical observations about treatment tolerability and infection rates, although these retrospective analyses should complement rather than replace randomized controlled trial evidence.

Panelists discuss how emerging combination strategies like acalabrutinib-venetoclax (AMPLIFY) and zanubrutinib-venetoclax (SEQUOIA Arm D) are expanding time-limited treatment options beyond the traditional venetoclax-obinutuzumab approach. However, they emphasize the need for longer follow-up data before widespread adoption and careful patient selection based on individual preferences and risk profiles.

Panelists discuss how to effectively mitigate Bruton tyrosine kinase (BTK) inhibitor toxicities through careful patient risk stratification, collaboration with cardio-oncologists, routine monitoring for arrhythmias and hypertension, appropriate use of dose reductions and drug holidays for chronic toxicities, and consideration of time-limited strategies to reduce long-term adverse effect exposure while maintaining treatment efficacy.

Panelists discuss how measurable residual disease (MRD) testing should be used primarily for prognostic information rather than routine treatment decision-making, with current guidelines recommending against using MRD results to alter therapy duration or change treatments. They question whether MRD negativity represents a sufficient surrogate end point for drug approvals, given the lack of cure potential and variable kinetics of MRD conversion.

Panelists discuss how obinutuzumab combinations with acalabrutinib (ELEVATE-TN data) and venetoclax (CLL14 data) provide compelling treatment options. The former shows continued progression-free survival benefits and curve separation over time, whereas the latter offers outstanding fixed-duration results even for high-risk patients. Both require careful consideration of intravenous (IV) vs oral preferences and long-term safety profiles.

Panelists discuss how the updated SEQUOIA Arm C data demonstrate that zanubrutinib monotherapy achieves a remarkable 72% progression-free survival at 5 years for high-risk patients with deletion 17p, showing similar outcomes to TP53 wild-type patients and establishing continuous monotherapy as an excellent option for these highest-risk patients.

Panelists discuss how to select among available Bruton tyrosine kinase (BTK) inhibitor treatment regimens for continuous vs fixed-duration strategies. They weigh the benefits of oral-only regimens against combination therapies that include intravenous (IV) infusions, while acknowledging the limited retreatment data for newer oral doublets.

Panelists discuss how the treatment landscape for treatment-naive patients with chronic lymphocytic leukemia (CLL) is rapidly evolving with new guideline updates every 6 to 12 months. They categorize approaches into fixed-duration vs continuous treatment strategies while emphasizing the need to study different molecular subtypes of CLL separately in future clinical trials.

Zydus Lifesciences gains FDA tentative approval for generic ibrutinib, enhancing access to vital cancer treatment for patients with CLL, SLL, and WM.

Promising results emerge from a phase 1b trial of azer-cel, an innovative CAR T-cell therapy, showing high response rates in DLBCL patients.

During a live event, Andrew H. Lipsky, MD, and participants discussed balancing efficacy, safety, and patient preferences when choosing CLL treatment.

New findings reveal that fixed-duration ibrutinib plus venetoclax offers long-term efficacy and safety for patients with untreated chronic lymphocytic leukemia.

A study reveals that venetoclax consolidation after BTKi therapy is effective for chronic lymphocytic leukemia, offering promising outcomes for patients.

Despite major advances, real-world data show diminishing survival outcomes and treatment-limiting toxicities in second line or later CLL treatment.

Pirtobrutinib shows significant benefits in progression-free survival and tolerability for relapsed CLL patients compared to standard treatments.

Zanubrutinib shows superior progression-free survival in chronic lymphocytic leukemia compared with acalabrutinib plus venetoclax, according to recent analysis.

New trial results reveal BGB-16673's promising safety and efficacy in treating relapsed CLL/SLL, showing significant antitumor activity across diverse patient profiles.

New data reveals bexobrutideg shows promising efficacy and safety in treating relapsed/refractory chronic lymphocytic leukemia, offering hope for patients.

Pirtobrutinib shows significant improvements in patient-reported outcomes for relapsed CLL/SLL, outperforming standard therapies in a recent trial.

DZD8586 achieved a high response rate in patients with relapsed/refractory CLL/SLL.

During a live event, Danielle M. Brander, MD, discussed use of zanubrutinib in high-risk chronic lymphocytic leukemia.

During a live event, John S. Renshaw, MD, and other oncologists discussed various trials of novel regimens for patients with chronic lymphocytic leukemia.

The FDA has approved a tablet version of zanubrutinib for all indications, improving convenience and reducing pill burden for patients with blood cancers.

The CAPTIVATE trial reveals long-term survival benefits of fixed-dose ibrutinib plus venetoclax for chronic lymphocytic leukemia patients, including high-risk groups.

Most CRS, ICANS, and neuro events after liso-cel were mild and occurred within 15 days post-infusion, according to different clinical trial and real-world settings.