In a recent issue of , researchers outlined the current first-line management options and considerations in chronic lymphocytic leukemia (CLL). The use of Bruton's tyrosine kinase (BTK) inhibitors and venetoclax (Venclexta) has led to significant progress in CLL in the first-line setting, but more studies are necessary to further investigate the sequencing of therapies for relapsed patients and second-line approaches.
In this ѻý video, Barbara Eichhorst, MD, of University Hospital Cologne in Germany, briefly discusses the sequencing of targeted therapies in CLL.
Following is a transcript of her remarks:
The data we have so far are mostly from those patients who still receive chemoimmunotherapy as front-line treatment. And when we look at those data where patients receive targeted agents from the second-line treatment on, and then as third-line treatment, we see that both ways around show good efficacy data if a BTK inhibitor was given first, and then venetoclax, or the other way around.
However, we know that relapses after chemoimmunotherapy tend to be more aggressive. We have more unfavorable prognostic genetic alterations. And therefore, it's for us right now that we need more information. At this time point where we are in kind of the luxury position that we have so many patients receiving front-line agents in remission. And therefore we have to look now for relapse treatment and for evaluating an optimal treatment sequence.
And I think we will have to wait here also for head-to-head comparison trials. And from these trials, one very important question will be what about second-line treatment and how do they work in those patients.