Dr. Barrientos on the Challenges in CLL

Jacqueline D. Barrientos, MD, MS, CLL Research and Treatment Program, Northwell Health Systems, discusses the current challenges oncologists are faced with in the field of chronic lymphocytic leukemia (CLL).

There is not enough data yet on sequencing treatments for patients with CLL. Oncologists are unsure of whether or not they should start with chemotherapy before moving to a tyrosine kinase inhibitor (TKI) and what is the best option for a patient that has either already failed on a TKI or demonstrated TKI intolerance, Barrientos says.

A big challenge is also understanding the difference between a patient that stops taking ibrutinib (Imbruvica) due to intolerance and a patient that has become truly refractory after developing a mutation that makes them no longer responsive. Barrientos says we also need answers on whether chemotherapy or targeted agents are better for these patients. There are several major phase III trials waiting to mature that should help with some of these challenges.