Dr. Al-Sawaf on the Limitations of Continuous Therapy Administration in CLL

Othman Al-Sawaf, MD, a physician with the University Hospital of Cologne in Germany, discusses the limitations of continuous therapy administration in chronic lymphocytic leukemia (CLL).

Historically, single-agent chemotherapy was given as fixed-duration options for about 6 cycles, explains Al-Sawaf. Although not all subgroups were eligible for chemotherapy monotherapy, patients who received the treatment were expected to be in remission and retain a prolonged treatment-free interval.

However, the advent of targeted therapies introduced continuous approaches to the paradigm, Al-Sawaf says. In CLL, BTK inhibitors, as well as venetoclax (Venclexta), are given as continuous therapies where patients are expected to remain on treatment until disease progression or unacceptable toxicity, explains Al-Sawaf.

While single-agent continuous therapy may yield some benefit, it can substantially impact quality of life, as patients need to remain on treatment for potentially many years to keep their disease under control, Al-Sawaf says. As such, more fixed-duration therapies are being evaluated in ongoing clinical trials, such as the phase 3 CLL14 study.