BSH 2022 | Novel combination therapies for the treatment of CLL
Francesco Forconi, MD, DM, PhD, FRCPath, University of Southampton, Southampton, UK, discusses the future treatment of chronic lymphocytic leukemia (CLL), drawing focus on novel combination therapies. Dr Forconi first highlights the importance of combining Bruton’s tyrosine kinase (BTK) inhibitors and BH3 mimetics, and the potential benefit of adding anti-CD20 monoclonal antibodies. Dr Forconi then mentions the possibility of bispecifics and chimeric antigen receptor T-cell (CAR-T) therapy for the treatment of relapsed/refractory (R/R) disease. To conclude, Dr Forconi highlights the promise of second and third generation BTK inhibitors in the treatment of R/R CLL, drawing focus on the promising results observed with the use of zanubrutinib in the ALPINE study (NCT03734016). This interview took place at the 62nd Annual Scientific Meeting of the British Society for Haematology (BSH) 2022, in Manchester, UK.
Transcript (edited for clarity)
So we were talking about the combination of BTK inhibitors and BH3 mimetics. This is certainly what we want to think of in the future. Depending on the BTK inhibitors that we are using, there might be a benefit or not around the use of anti-CD20 monoclonal antibodies. Certainly the combination of these three types, the three classes of drugs, BTK inhibitors, or BCR inhibitors in general, BH3 mimetics, and anti-CD20 antibodies, are the backbone for any future treatment in CLL...
So we were talking about the combination of BTK inhibitors and BH3 mimetics. This is certainly what we want to think of in the future. Depending on the BTK inhibitors that we are using, there might be a benefit or not around the use of anti-CD20 monoclonal antibodies. Certainly the combination of these three types, the three classes of drugs, BTK inhibitors, or BCR inhibitors in general, BH3 mimetics, and anti-CD20 antibodies, are the backbone for any future treatment in CLL. Certainly we will like also to think about bispecific antibodies or CAR-Ts where the backbone treatment is not able to operate anymore. And so maybe these two different types of treatment to be considered at the moment for relapsed/refractory patients.
There are some interesting highlights from the second, third generation of BTK inhibitors in CLL at BSH. Where we see that the novel, the third generation of BTK inhibitors, one of these is zanubrutinib, may seem to have a better progression-free survival at least in the relapsed/refractory patients. This is the study from the ALPINE trial in which zanubrutinib seems to associate with a longer progression-free survival than BTK inhibitors, like ibrutinib.
Read more...
