Dr. Thompson on Emerging Treatment Strategies With BTK Inhibitors in CLL

Meghan Thompson, MD, third-year fellow, Hematology and Medical Oncology, Memorial Sloan Kettering Cancer Center, discusses emerging treatment strategies with BTK inhibitors in chronic lymphocytic leukemia (CLL).

Significant data are emerging with BTK inhibitor–based treatment strategies in CLL, says Thompson. Single-agent zanubrutinib (Brukinsa) could offer a third single-agent BTK inhibitor option for this patient population that could yield a more favorable safety profile compared with ibrutinib (Imbruvica) and acalabrutinib (Calquence), Thompson says.

Additionally, non-covalent BTK inhibitors are emerging as potential treatments, but additional data are needed to determine where these agents will fit into sequencing among the covalent BTK inhibitors, as well as venetoclax (Venclexta), Thompson explains.

Combination strategies with BTK inhibitors are also an exciting advancement in CLL, Thompson says. For example, data from the primary analysis of the fixed-duration cohort of the phase 2 CAPTIVATE study (NCT02910583) were presented during the 2021 ASCO Annual Meeting. Patients with treatment-naïve CLL or small lymphocytic lymphoma received a 3-cycle lead-in dose of ibrutinib followed by 12 cycles of ibrutinib plus venetoclax, Thompson says. The overall response rate was 96% in all treated patients, Thompson says.

As such, fixed-duration therapy offers an appealing strategy for patients with CLL who would prefer to have a treatment-free remission vs receive continuous therapy, Thompson concludes.