Dr. Woyach on the Utility of Time-Limited Therapies in CLL

Jennifer Woyach, MD, associate professor, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center—James, discusses the utility of time-limited therapies in chronic lymphocytic leukemia (CLL).

Historically, time-limited therapies were commonly used in CLL with chemoimmunotherapy, says Woyach. However, the field began to move toward continuous therapy with the advent of BTK inhibitor­-based treatments.

Notably, minimal residual disease (MRD)­-negative complete responses (CR) are less common with BTK inhibitor-based treatments, explains Woyach.

Recently, time-limited therapy with venetoclax (Venclexta)/rituximab (Rituxan) in the relapsed/refractory setting and venetoclax/obinutuzumab (Gazyva) in the frontline setting have demonstrated high rates of MRD-negative CRs in patients with CLL, says Woyach. Additionally, longer-term follow-up with these combinations suggests that patients who obtain deep remissions are more likely to have prolonged remissions following treatment discontinuation.

While assessing for MRD after treatment is not currently the standard of care, personalizing this approach for individual patients may have utility in the future, concludes Woyach.