Dr. Barrientos on Advances in the Treatment Landscape for Patients With CLL

Jacqueline C. Barrientos, MD, associate professor, The Feinstein Institute for Medical Research, Northwell Health, discusses advances in the treatment landscape for patients with chronic lymphocytic leukemia (CLL).

Physicians are very excited about the most recent FDA approval of venetoclax (Venclexta), a BCL-2 inhibitor, in combination with rituximab (Rituximab) for all patients with CLL. Venetoclax has proven to be effective following failure on ibrutinib (Imbruvica) or idelalisib (Zydelig), says Barrientos. The approval gives patients another option, especially those who undergo a major surgery or experience atrial fibrillation. Venetoclax widens the possible therapeutic options, Barrientos explains.

Venetoclax has never been put against ibrutinib in a head-to-head comparison, but both agents have great clinical activity in the relapsed/refractory setting and as well as in patients who have 17p deletion. In selecting therapy, it is important to balance the clinical characteristics of the patient, explains Barrientos, as certain comorbidities are associated with greater intolerance to specific agents. For example, ibrutinib could worsen the bleeding or the arrhythmia.