Dr. Woyach on Remaining Sequencing Questions in CLL

Jennifer Woyach, MD, a hematologist-oncologist and an associate professor within the Department of Internal Medicine at the Ohio State University Comprehensive Cancer Center–James, discusses remaining sequencing questions within the field of chronic lymphocytic leukemia (CLL).

Several updates have recently read out in the frontline CLL space, says Woyach. For example, results from the phase 3 CLL14 study with venetoclax (Venclexta) plus obinutuzumab (Gazyva) have been shared, as well as updates on studies examining acalabrutinib (Calquence) or ibrutinib (Imbruvica), where the most long-term data exist, according to Woyach.

One question that still needs to be addressed in this space is, Does it matter how these novel therapies are sequenced? Most of the available trial data are on patients who come off of a BTK inhibitor and then are treated with venetoclax. It has always been a question as to whether a patient could successfully transition from venetoclax to a BTK inhibitor. No prospective data are available in that setting, but accumulating data from retrospective studies suggest that this could be a very successful strategy. Most patients who are treated with venetoclax and relapse on or after treatment can successfully be treated with a BTK inhibitor, concludes Woyach.