Dr. Barrientos on Selecting Between BCL-2 Inhibitors and BTK Inhibitors in CLL

Jacqueline Claudia Barrientos, MD, MS, an associate professor at the Karches Center for Oncology Research, Feinstein Institutes for Medical Research, as well as an associate professor in the Division of Hematology and Medical Oncology, Department of Medicine, at the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, discusses factors to consider when selecting between BCL-2 inhibitors and BTK inhibitors in chronic lymphocytic leukemia (CLL).

Patients with newly diagnosed CLL have the option to receive the BCL-2 inhibitor venetoclax (Venclexta) or a BTK inhibitor, such as ibrutinib (Imbruvica) or acalabrutinib (Calquence), says Barrientos.

It is important to discuss socioeconomic factors with a patient when selecting between these agents, Barrientos says. For example, some patients may not be able to afford BTK inhibitor therapy indefinitely, so fixed-duration venetoclax may be optimal in those cases, Barrientos explains.

Toxicity should also be weighed during treatment selection, Barrientos explains. Some patients do not want the risk of tumor lysis syndrome associated with venetoclax and may prefer to receive a BTK inhibitor, Barrientos says.

Ultimately, without head-to-head data comparing venetoclax with BTK inhibitors, ensuring that each patient’s therapy is tailored to their individual needs is critical, concludes Barrientos.