Sameh Gaballa, MD, of Moffitt Cancer Center; M. Yair Levy, MD, of Texas Oncology–Baylor Charles A. Sammons Cancer Center; and Andrew H. Lipsky, MD, of Columbia University Irving Medical Center, discuss how they choose between continuous Bruton tyrosine kinase inhibitor therapy and fixed-duration, venetoclax-based therapy for patients with treatment-naive chronic lymphocytic leukemia, including genomic testing, long-term trial data, cardiac and infection safety, retreatment, the first-line role of pirtobrutinib, and next-generation agents.
Sameh Gaballa, MD, of Moffitt Cancer Center, opens this OncLive Insights program on treatment-naive chronic lymphocytic leukemia (CLL) by asking where continuous Bruton tyrosine kinase (BTK) inhibitor therapy and fixed-duration, venetoclax-based therapy fit today.
M. Yair Levy, MD, of Texas Oncology–Baylor Charles A. Sammons Cancer Center, explains why risk stratification matters even though targeted therapy is recommended for every patient with chronic lymphocytic leukemia (CLL): expectations and reality need to line up, and treatment goals differ.
Sameh Gaballa, MD, of Moffitt Cancer Center, asks what the faculty look for when they read randomized trials in treatment-naive chronic lymphocytic leukemia (CLL).
Andrew H. Lipsky, MD, of Columbia University Irving Medical Center, reviews long-term data with continuous Bruton tyrosine kinase (BTK) inhibitors in treatment-naive chronic lymphocytic leukemia (CLL).
Sameh Gaballa, MD, of Moffitt Cancer Center, asks when the faculty add obinutuzumab to acalabrutinib.
M. Yair Levy, MD, of Texas Oncology–Baylor Charles A. Sammons Cancer Center, explains that second-generation Bruton tyrosine kinase (BTK) inhibitors have more focused kinase profiles, so acalabrutinib and zanubrutinib carry a better cardiovascular profile than ibrutinib and are favored in guidelines.
Andrew H. Lipsky, MD, of Columbia University Irving Medical Center, describes his ideal candidate for fixed-duration therapy in treatment-naive chronic lymphocytic leukemia (CLL).
Sameh Gaballa, MD, of Moffitt Cancer Center, asks whether the approval of all-oral fixed-duration acalabrutinib plus venetoclax has changed practice.
Sameh Gaballa, MD, of Moffitt Cancer Center, asks the faculty to interpret CLL17, the first phase 3 trial to compare fixed-duration and continuous therapy in treatment-naive chronic lymphocytic leukemia (CLL).
Sameh Gaballa, MD, of Moffitt Cancer Center, notes that infection rates in CLL17 were higher in the venetoclax plus obinutuzumab arm and asks how that shapes treatment selection in chronic lymphocytic leukemia (CLL).
Sameh Gaballa, MD, of Moffitt Cancer Center, asks what to watch for in patients who have been on a Bruton tyrosine kinase (BTK) inhibitor for years.
Sameh Gaballa, MD, of Moffitt Cancer Center, asks where pirtobrutinib, the noncovalent Bruton tyrosine kinase (BTK) inhibitor newly approved for first-line chronic lymphocytic leukemia (CLL), fits and whether starting with it burns the bridge to covalent agents.
