Dr. Barrientos on the Shift Away From Chemoimmunotherapy in CLL

Jacqueline Claudia Barrientos, MD, MS, associate professor, Karches Center for Oncology Research, Feinstein Institutes for Medical Research, associate professor, Division of Hematology and Medical Oncology, Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, discusses the shift away from chemoimmunotherapy in chronic lymphocytic leukemia (CLL).

Historically, chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) was the standard of care treatment for fit patients with CLL who did not have significant comorbidities, says Barrientos. FCR was used in patients with mutated IGHV who did not harbor 17p or 11q deletions because they were able to derive long-term responses from the fixed-duration therapy, Barrientos adds.

However, chemoimmunotherapy was associated with severe infections that required hospitalization, as well as severe myelosuppression, says Barrientos. As such, chemoimmunotherapy was not optimal for many elderly patients with CLL, and the field has shifted to utilize less toxic regimens, concludes Barrientos.