Long-Term Data With Continuous BTK Inhibitors in Treatment-Naive 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). He cites a median progression-free survival (PFS) of 8.9 years with ibrutinib in RESONATE-2 and strong results for acalabrutinib in ELEVATE-TN and zanubrutinib in SEQUOIA, including the 7-year SEQUOIA readout. In his reading, predictive biomarkers matter less with BTK inhibitors: a roughly 10-point PFS gap between patients with 17p deletion and those with wild-type TP53 takes until about year 6 to appear. Sameh Gaballa, MD, of Moffitt Cancer Center, notes the SEQUOIA subgroup aged 80 years or older, with about 65% of patients progression free at 72 months. M. Yair Levy, MD, of Texas Oncology–Baylor Charles A. Sammons Cancer Center, stresses how well tolerated these agents are, even in patients in their 90s, with no absolute age cutoff.