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Optimizing R/R CLL Treatment: Therapy Sequencing and Supportive Care Strategies

The Current Treatment Landscape for R/R CLL

Video content above is prompted by the following:

Please discuss the current treatment landscape for relapse/refractory chronic lymphocytic leukemia.

Videos

Nitin Jain, MD, and Joanna M. Rhodes, MD, MDCS, discuss how various aspects of chronic lymphocytic leukemia (CLL) management are approached, including treatment selection based on prior therapies and patient factors, the use of novel agents such as pirtobrutinib, strategies for relapsed/refractory (R/R) disease, treatment sequencing, and the role of multidisciplinary teams in optimizing patient care and outcomes.

Panelists discuss the current standard of care and treatment landscape for patients with chronic lymphocytic leukemia.

Panelists discuss how the choice of prior therapy between BTK inhibitors and BCL2 inhibitors influences subsequent treatment decisions in chronic lymphocytic leukemia (CLL), considering factors such as resistance mechanisms, toxicity profiles, and patient-specific characteristics.

Impact of Prior BTKi vs BCL2i Therapy on Treatment Decision-Making in CLL 

Panelists discuss how various patient-specific factors, including age, comorbidities, performance status, disease aggressiveness, symptoms, and biomarkers, are carefully considered to guide the selection of optimal treatment strategies for individuals with chronic lymphocytic leukemia (CLL).

Key Patient-Specific Factors Guiding Treatment Selection in CLL 

Panelists discuss how treatment approaches are tailored differently for patients with rapid, aggressive chronic lymphocytic leukemia progression versus those with slower, less aggressive disease, considering factors such as urgency of intervention, choice of therapy intensity, and long-term management strategies.

Tailoring Treatment Approaches for Rapid vs. Slow Disease Progression in CLL 

Panelists discuss how they assess patients for resistance to first-line BTK inhibitor therapy in chronic lymphocytic leukemia, emphasizing the importance of clinical evaluation, laboratory testing, and genetic analysis in determining the presence and mechanisms of resistance to guide subsequent treatment decisions.

Assessing Resistance to First-Line BTK Inhibitor Therapy: The Emergine Role of Testing in CLL

Panelists discuss how the non-covalent BTK inhibitor pirtobrutinib has shown promising results in the BRUIN clinical trials for both BTK inhibitor-naive and previously treated chronic lymphocytic leukemia patients, reviewing key efficacy and safety data presented at recent hematology conferences.

Pirtobrutinib in the Management of R/R CLL: Updates from the BRUIN Trial

Panelists discuss how utilizing pirtobrutinib in clinical practice, focusing on its application in patients who have developed resistance or intolerance to prior BTK inhibitors, as well as in those who have shown resistance to both BTK and BCL-2 inhibitors in chronic lymphocytic leukemia treatment.

Application of Pirtobrutinib in R/R CLL: Expert Perspectives

Panelists discuss how they evaluate patients for tumor lysis syndrome (TLS) risk, considering factors such as tumor burden, renal function, and prior therapies, and how this assessment influences their decision between prescribing a non-covalent BTK inhibitor or a venetoclax-based regimen for chronic lymphocytic leukemia treatment.

Influence of TLS Risk and Patient Preferences on Treatment Selection in Relapsed/Refractory CLL

Panelists discuss how various additional treatment options for relapsed/refractory chronic lymphocytic leukemia (CLL) are considered, including CAR-T cell therapy, immunomodulatory drugs like lenalidomide, chemoimmunotherapy regimens, and other emerging therapies, highlighting their potential roles in the evolving treatment landscape.

Navigating treatment strategies for patients with multi-refractory CLL: CAR-T, ASCT, and PI3K Inhibitors

Panelists discuss how they approach treatment selection for multi-refractory chronic lymphocytic leukemia (CLL) patients, considering factors such as prior therapy responses, patient fitness, and disease characteristics to guide choices among available options, including CAR T-cell therapy, while also addressing the limitations and challenges associated with each treatment modality in their decision-making process.

Sequencing and Combination Strategies with Pirtobrutinib and CAR-T Therapy in R/R CLL

Panelists discuss how they approach treatment sequencing in relapsed/refractory chronic lymphocytic leukemia (CLL), considering primary factors such as prior therapies, mechanisms of resistance, patient characteristics, and treatment goals to optimize the order and selection of subsequent therapies for improved long-term outcomes.

Treatment Sequencing in Relapsed/Refractory CLL: Key Factors Influencing Decision-Making

Panelists discuss how they balance the potential benefits of aggressive first-line treatment in chronic lymphocytic leukemia against the importance of preserving effective options for subsequent lines of therapy, considering factors such as patient prognosis, treatment goals, and the evolving landscape of available therapies.

The Current Treatment Landscape for R/R CLL

EP: 1.The Current Treatment Landscape for R/R CLL

EP: 2.Impact of Prior BTKi vs BCL2i Therapy on Treatment Decision-Making in CLL

EP: 3.Key Patient-Specific Factors Guiding Treatment Selection in CLL

EP: 4.Tailoring Treatment Approaches for Rapid vs. Slow Disease Progression in CLL

EP: 5.Assessing Resistance to First-Line BTK Inhibitor Therapy: The Emergine Role of Testing in CLL

EP: 6.Pirtobrutinib in the Management of R/R CLL: Updates from the BRUIN Trial

EP: 7.Application of Pirtobrutinib in R/R CLL: Expert Perspectives

EP: 8.Influence of TLS Risk and Patient Preferences on Treatment Selection in Relapsed/Refractory CLL

EP: 9.Navigating treatment strategies for patients with multi-refractory CLL: CAR-T, ASCT, and PI3K Inhibitors

EP: 10.Sequencing and Combination Strategies with Pirtobrutinib and CAR-T Therapy in R/R CLL

EP: 11.Treatment Sequencing in Relapsed/Refractory CLL: Key Factors Influencing Decision-Making

EP: 12.Emerging role of doublet triplet therapies in R/R CLL: Expert Perspectives

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