Dr. Davids on Factors to Inform Treatment Selection in CLL

Matthew S. Davids, MD, MMSc, director of clinical research in the Lymphoma Program and a medical oncologist with Dana-Farber Cancer Institute, as well as an assistant professor of medicine at Harvard Medical School, discusses factors to consider when selecting treatment for patients with chronic lymphocytic leukemia (CLL).

When deciding which modality to select for patients with CLL, comorbidities must be considered, says Davids. For example, if there is a patient with significant cardiovascular disease, particularly if he/she is on an anticoagulation medication for atrial fibrillation, BTK inhibitors may not be the optimal choice. For this patient, a venetoclax (Venclexta)-based regimen should be considered, according to Davids.

On the other hand, if a patient has poor renal function and tumor lysis risk is a concern or if he/she is older and has difficulty commuting to the medical center for frequent monitoring, then a BTK inhibitor is favored, says Davids. With this approach, there is less risk of tumor lysis and patients require less monitoring than they would with a venetoclax-based regimen, concludes Davids.