Dr. Burger on Choosing Frontline Therapy in CLL

Jan A. Burger, MD, PhD, tenured professor, Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, “privatdozent” (lecturer) in internal medicine, Albert-Ludwigs University, School of Medicine, Freiberg, Germany, faculty, Graduate School of Biomedical Sciences, University of Texas-Houston Health Science Center, discusses choosing frontline therapy in chronic lymphocytic leukemia (CLL).

The BTK inhibitors ibrutinib (Imbruvica) and acalabrutinib (Calquence) are widely utilized frontline options for patients with CLL, Burger explains. Both agents are active and choosing between them is largely based on differences in their toxicity profiles, including blood pressure complications and atrial fibrillation.

The BCL-2 inhibitor venetoclax (Venclexta) is also available for frontline use. Like the BTK inhibitors, venetoclax is given orally. However, the agents differ in that venetoclax, which is often combined with agents like obinutuzumab (Gazyva) or rituximab (Rituxan), is given in a fixed-duration regimen, whereas BTK inhibitors are given continuously for an indefinite period, Burger says.

Ultimately, treatment selection should be based on patient preference, safety profiles, and eligibility for clinical trials, Burger concludes.