For patients with chronic lymphocytic leukemia, including those with high-risk disease, the availability of novel targeted therapies and monoclonal antibodies offers an increased potential for improved outcomes.
In December 2018, pivotal trial data were presented at the ASH Annual Meeting that demonstrated promising results for the first-line treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic leukemia. In particular, new courses of CLL care in several patient populations emerged from the findings of 3 trials.
Matthew S. Davids, MD, MMSc, characterizes the significance of the ALLIANCE, ECOG E1912, and iLLUMINATE trials within the broader treatment spectrum for chronic lymphocytic leukemia.
Jennifer Woyach, MD, discusses the current treatment spectrum of chronic lymphocytic leukemia and the significance of the ALLIANCE trial.
There have been updates in chronic lymphocytic leukemia prevalence and diagnosis, with an emphasis on testing options.
The European Medicines Agency’s Committee for Medicinal Products for Human Use has recommended expanding the indications of ibrutinib (Imbruvica) to include use in combination with obinutuzumab (Gazyva) for adult patients with previously untreated chronic lymphocytic leukemia, and also in combination with rituximab (Rituxan) for the treatment of adult patients with Waldenström’s macroglobulinemia.
Jennifer Woyach, MD, discusses the 3-year follow-up from the single-arm study of the combination of acalabrutinib (Calquence) and obinutuzumab (Gazyva) showcase the efficacy of the regimen in both patients with treatment-naïve and relapsed/refractory chronic lymphocytic leukemia and the future of treatment in the space.
Patients with high-risk relapsed/refractory chronic lymphocytic leukemia who failed or were intolerant of ibrutinib derived more benefit from CD19‐targeted CAR T-cell therapy when the BTK inhibitor was concurrently administered than when it was not.
The CAR T-cell therapy lisocabtagene maraleucel demonstrated high rates of response, including minimum residual disease in blood and marrow in patients with relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma.
Acalabrutinib elicited high rates of response as well as prolonged survival and was well tolerated in patients with chronic lymphocytic leukemia who demonstrated intolerance to ibrutinib.