In season 3, episode 4 of Targeted Talks, Alexey Danilov, MD, PhD, discusses the shift toward utilizing cellular therapy to treat high-risk patients with chronic lymphocytic leukemia.
In season 3, episode 4 of Targeted Talks, Alexey Danilov, MD, PhD, associate director, Toni Stephenson Lymphoma Center, and professor, Division of Lymphoma, Department of Hematology & Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Center, discusses the shift toward utilizing cellular therapy to treat high-risk patients with chronic lymphocytic leukemia (CLL).
The definition of high-risk has changed in CLL based on the emergence of better therapies. Today, patients with tp53 mutations, complex karyotype, and patients who have progressed while on targeted therapies are considered to be high risk.
Historically for the high-risk CLL population, allogeneic stem cell transplant and chemoimmunotherapy were the standards of care. The treatment landscape has since expanded to include Bruton’s tyrosine kinase (BTK) inhibitors and BCL-2 inhibitors. These newer drug classes can be used sequentially and in the clinical trial setting, they are being investigated as combinations. PI3K inhibitors are also available and effective for the treatment of high-risk CLL.
The role of transplant is after patients progress on available targeted therapies.
In terms of cellular therapies have been another positive development for high-risk CLL, says Danilov. In studies, responses to chimeric antigen receptor (CAR) T-cell therapy have been observed in patients with deletion 17p and those who are refractory to BTK inhibitors. The next step with CAR T cells is understanding the durability of response and learning better ways to handle severe toxicities like cytokine release syndrome.
The latest treatment strategies being investigated for high-risk CLL include CAR T-cell therapy combined with targeted therapies, novel BTK inhibitors for BTK-refractory patients, and natural killer cells, explains Danilov.
Leslie Reviews Relevant Data for Treatment of Relapsed/Refractory CLL
May 8th 2024During a Case-Based Roundtable® event, Lori A. Leslie, MD, discussed Bruton tyrosine kinase inhibition options for a patient with relapsed/refractory chronic lymphocytic leukemia in the first article of a 2-part series.
Read More
Marks Explores Cardiac Toxicities and Dosing Concerns of BTK Inhibitors in CLL
April 26th 2024During a Case-Based Roundtable® event, Stanley M. Marks, MD, moderated a discussion on the impact of cardiac adverse events on patients who receive a Bruton tyrosine kinase inhibitor for chronic lymphocytic leukemia.
Read More
Considering the Durability of Zanubrutinib in Relapsed/Refractory CLL
April 11th 2024During a Case-Based Roundtable® event, Marc S. Hoffmann, MD, discussed his viewpoints on the use of Bruton tyrosine kinase inhibitors for patients with relapsed/refractory chronic lymphocytic leukemia and the efficacy behind zanubrutinib in the second article of a 2-part series.
Read More
Acalabrutinib/Obinutuzumab Shows Improved PFS in Treatment-Naive CLL
April 10th 2024In an interview with Targeted Oncology, Jeff Sharman, MD, discussed the results of the ELEVATE-TN trial of acalabrutinib with or without obinutuzumab at 74.5 months of follow-up among patients with chronic lymphocytic leukemia.
Read More