Optimizing R/R CLL Treatment: Therapy Sequencing and Supportive Care Strategies

Panelists discuss the current standard of care and treatment landscape for patients with chronic lymphocytic leukemia.

Panelists discuss how the choice of prior therapy between BTK inhibitors and BCL2 inhibitors influences subsequent treatment decisions in chronic lymphocytic leukemia (CLL), considering factors such as resistance mechanisms, toxicity profiles, and patient-specific characteristics.

Panelists discuss how various patient-specific factors, including age, comorbidities, performance status, disease aggressiveness, symptoms, and biomarkers, are carefully considered to guide the selection of optimal treatment strategies for individuals with chronic lymphocytic leukemia (CLL).

Panelists discuss how treatment approaches are tailored differently for patients with rapid, aggressive chronic lymphocytic leukemia progression versus those with slower, less aggressive disease, considering factors such as urgency of intervention, choice of therapy intensity, and long-term management strategies.

Panelists discuss how they assess patients for resistance to first-line BTK inhibitor therapy in chronic lymphocytic leukemia, emphasizing the importance of clinical evaluation, laboratory testing, and genetic analysis in determining the presence and mechanisms of resistance to guide subsequent treatment decisions.

Panelists discuss how the non-covalent BTK inhibitor pirtobrutinib has shown promising results in the BRUIN clinical trials for both BTK inhibitor-naive and previously treated chronic lymphocytic leukemia patients, reviewing key efficacy and safety data presented at recent hematology conferences.

Panelists discuss how utilizing pirtobrutinib in clinical practice, focusing on its application in patients who have developed resistance or intolerance to prior BTK inhibitors, as well as in those who have shown resistance to both BTK and BCL-2 inhibitors in chronic lymphocytic leukemia treatment.

Panelists discuss how they evaluate patients for tumor lysis syndrome (TLS) risk, considering factors such as tumor burden, renal function, and prior therapies, and how this assessment influences their decision between prescribing a non-covalent BTK inhibitor or a venetoclax-based regimen for chronic lymphocytic leukemia treatment.

Panelists discuss how various additional treatment options for relapsed/refractory chronic lymphocytic leukemia (CLL) are considered, including CAR-T cell therapy, immunomodulatory drugs like lenalidomide, chemoimmunotherapy regimens, and other emerging therapies, highlighting their potential roles in the evolving treatment landscape.

Panelists discuss how they approach treatment selection for multi-refractory chronic lymphocytic leukemia (CLL) patients, considering factors such as prior therapy responses, patient fitness, and disease characteristics to guide choices among available options, including CAR T-cell therapy, while also addressing the limitations and challenges associated with each treatment modality in their decision-making process.

Panelists discuss how they approach treatment sequencing in relapsed/refractory chronic lymphocytic leukemia (CLL), considering primary factors such as prior therapies, mechanisms of resistance, patient characteristics, and treatment goals to optimize the order and selection of subsequent therapies for improved long-term outcomes.

Panelists discuss how they balance the potential benefits of aggressive first-line treatment in chronic lymphocytic leukemia against the importance of preserving effective options for subsequent lines of therapy, considering factors such as patient prognosis, treatment goals, and the evolving landscape of available therapies.

Panelists discuss how emerging resistance patterns in chronic lymphocytic leukemia influence their approach to treatment sequencing, considering the mechanisms of resistance to different drug classes and how this knowledge informs the selection and order of therapies to maximize long-term disease control and patient outcomes.

Panelists discuss how their institutions organize multidisciplinary teams for chronic lymphocytic leukemia care, detailing the specific roles of various specialists including oncologists, nurses, pharmacists, and cardiologists in coordinating comprehensive patient care, managing adverse events, and addressing treatment-related complications throughout the course of therapy.