Chronic Lymphocytic Leukemia

Jeff Sharman, MD, reviews the initial presentation, clinical workup, and treatment of the case of a 73-year-old woman with chronic lymphocytic leukemia and shares insight into the patient’s prognosis and risk stratification.

A nonrandomized phase 2 trial of ibrutinib plus venetoclax in patients with treatment naïve chronic lymphocytic leukemia showed durable remissions after more than 3 years of follow-up.

With longer follow-up, significant responses were still observed with the BTK inhibitor zanubrutinib as a single agent in patients with relapsed or refractory chronic lymphocytic leukemia in the phase 2 BGB-3111-205 trial.

With further follow-up from the phase 3 CLL14 trial, the median progression-free survival was still reached with the fixed-dose regimen of venetoclax and obinutuzumab in patients with previously untreated chronic lymphocytic leukemia.

A combination of zandelisib and zanubrutinib induced significant responses, including several complete responses in patients with relapsed or refractory chronic lymphocytic leukemia and other B-cell lymphomas in a phase 1b study, the results of which were presented during the 2021 European Hematology Association Annual Congress.

In an interview with Targeted Oncology, Peter Hillmen, MD, PhD, discussed the results of the head-to-head trial comparing acalabrutinib and ibrutinib, as well as future directions for Bruton's tyrosine kinase inhibitors in chronic lymphocytic leukemia.

A fixed duration of ibrutinib plus venetoclax led to a significant progression-free survival benefit over chlorambucil plus obinutuzumab as frontline treatment in patients with chronic lymphocytic leukemia, according to a primary analysis of the phase 3 GLOW study presented at the European Hematology Association 2021 Virtual Congress.

Interim results from the phase 3 ALPINE trial suggest that treatment with zanubrutinib may be superior to treatment with ibrutinib for patients with relapsed or refractory chronic lymphocytic leukemia and small lymphocytic lymphoma.

Over half, 56%, of patients with chronic lymphocytic leukemia and small lymphocytic lymphoma who were treated with The combination of ibrutinib plus venetoclax produced a complete response and complete response with incomplete bone marrow recovery

Lisaftoclax, a novel BCL-2 inhibitor, has demonstrated encouraging responses with acceptable safety in patients with chronic lymphocytic leukemia and small lymphocytic lymphoma, and other hematologic cancers who were treated in first-in-human phase 1 trial.

Patients with chronic lymphocytic leukemia and small lymphocytic lymphoma treated with the combination of ibrutinib plus venetoclax had complete response and complete response with a 56% incomplete bone marrow recover rate in the phase 2 CAPTIVATe study.

In select previously treated patients with chronic lymphocytic leukemia, treatment with acalabrutinib was found to be noninferior but better tolerated compared with ibrutinib.

Encouraging clinical and pharmacodynamic activity was seen at all dose levels in patients with B-cell malignancies who received TG-1701.

Based on 7-year follow-up data, the use of front-line ibrutinib monotherapy has sustained progression-free survival and overall survival benefit compared with chlorambucil as treatment of patients with chronic lymphocytic leukemia.

The combination of cirmtuzumab and ibrutinib achieved high overall response rates in patients with mantle cell lymphoma or chronic lymphocytic leukemia who were treated in a phase 1/2 study.

Alexey Danilov, MD, a hematologist oncologist at the City of Hope Comprehensive Cancer Center, discusses treatment options for relapsed/refractory chronic lymphocytic leukemia.

The FDA has accepted the biologic license application (BLA) for ublituximab in combination with umbralisib for the treatment of patients with chronic lymphocytic leukemia and small lymphocytic lymphoma.

The combination of ibrutinib and venetoclax showed a favorable benefit-risk profile in patients with relapsed or refractory chronic lymphocytic leukemia treated in the VISION/HOVON 141.

Seema A. Bhat, MD, discussed the case of 61-year-old patient with chronic lymphocytic leukemia during a Targeted Oncology Case-Based Roundtable event.

Targeting different pathways may dramatically reduce the risk of resistance emergence and improve outcomes.

Findings suggest that combination regimens may extend overall and progression-free survival.

John N. Allan, MD, discusses a pooled analysis of 4 clinical trials with 4-year follow-up of first-line ibrutinib in patients with chronic lymphocytic leukemia and TP53 aberration deletion 17p or a TP53 mutation.

In an interview with Targeted Oncology, Mato, a hematologic oncologists and the director of the CLL Program at Memorial Sloan Kettering Cancer Center, discussed biomarker testing in CLL, and the future of BTK inhibitors in the CLL paradigm. 

Roughly 4% of patients with chronic lymphocytic leukemia treated with ibrutinib may experience atrial fibrillation, but their comorbidities, rather than their CLL-related factors, predict risk of treatment-emergent AF.

The use of zanubrutinib was found to be noninferior to treatment with ibrutinib for adult patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma, meeting the primary end point of the phase 3 ALPINE trial.

William G. Wierda, MD, PhD, discusses the synergy between ibrutinib and venetoclax in patients with chronic lymphocytic leukemia.

In an interview with Targeted Oncology, Jennifer R. Brown, MD, PhD, discusses the chance of cardiovascular toxicities with BTK inhibitors and the safety of acalabrutinib.

In an interview with Targeted Oncology, John N. Allan, MD, a hematology oncologist at Weill Cornell Medicine, discussed how ibrutinib extends PFS in patients with CLL. He also discussed combination therapy in the future of CLL treatment.

The rolling submission of a Biologics License Application for the combination of ublituximab and umbralisib for the treatment of chronic lymphocytic leukemia has been completed for submission to the FDA.

Patients with relapsed or refractory high-risk chronic lymphocytic leukemia achieved a statistically higher rate of overall response when the glycoengineered, type I anti-CD20 monoclonal antibody ublituximab was added to the Bruton’s tyrosine kinase inhibitor ibrutinib, according to results from the phase 3 GENUINE study.