Dr. Barrientos on Treatment Considerations for CLL

Jacqueline Claudia Barrientos, MD, MS, an associate professor at the Karches Center for Oncology Research, Feinstein Institutes for Medical Research, as well as an associate professor in the Division of Hematology and Medical Oncology, Department of Medicine, at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, discusses treatment considerations for patients with chronic lymphocytic leukemia (CLL).

It's important to check for prognostic markers in order to determine whether the patient has a mutation, according to Barrientos. For patients who have mutations, a targeted agent should be utilized for treatment, she explains. For patients with a 17p deletion, targeted agents or prioritization for clinical trial participation are recommended, Barrientos explains.

For patients who have trouble with treatment compliance, Barrientos would recommend a regimen such as obinutuzumab (Gazyva) plus venetoclax (Venclexta), as it is a time-limited strategy that is given for 1 year. This treatment regimen has demonstrated excellent overall response rates and time in remission, as well as possibly being easier for patients who have issues with treatment compliance over a long period of time, Barrientos notes.

Additionally, if a patient has a recent history of major surgery or spontaneous bleeding in the central nervous system, a BTK inhibitor should be avoided in order to prevent a relapse from that bleeding event, Barrientos concludes.