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ESH CLL 2026 | Future role of BTK degraders in CLL treatment
Justin Taylor, MD, University of Miami Sylvester Comprehensive Cancer Center, Miami, FL, discusses how BTK degraders may be integrated into treatment sequencing for chronic lymphocytic leukemia (CLL). He explores their emerging role in relapsed/refractory CLL, their potential to complement or replace existing BTK inhibitors, and how ongoing trials may shape their use in earlier lines of therapy over the next decade. This interview took place at the ESH CLL 2026 congress in Stockholm, Sweden.
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Transcript
So right now the trials are all studying the degraders after patients have already received covalent BTK inhibitors, and in most cases already venetoclax or BCL2 inhibitor-based treatment. So right now that’s the data we have, and they’re not yet approved even for that indication, but they seem to be working so far in the trials. So I would think that that would be kind of the first place to use them is after failure of a BTK inhibitor and a BCL2 inhibitor, the so-called double-exposed or double-refractory patients...
So right now the trials are all studying the degraders after patients have already received covalent BTK inhibitors, and in most cases already venetoclax or BCL2 inhibitor-based treatment. So right now that’s the data we have, and they’re not yet approved even for that indication, but they seem to be working so far in the trials. So I would think that that would be kind of the first place to use them is after failure of a BTK inhibitor and a BCL2 inhibitor, the so-called double-exposed or double-refractory patients. But I do see them potentially moving into frontline after that, such as we’ve done with other therapies like pirtobrutinib or the non-covalent BTK inhibitor. I think they can be complementary. Like I mentioned, we can use them after the other lines of therapy have failed. But also, I’m sure we will be investigating them as potentially able to replace because of those properties we spoke about that are favorable for degraders in terms of fighting resistance mutations and the dosing. Also, you know, potentially less side effects than some of the BTK inhibitors. Although that needs to be tested in clinical trials, I could see them one day maybe replacing those drugs. Right now, they’re still in clinical trials. And if they were to get approved, would probably be first approved in that relapsed refractory setting. But maybe the trials are going to start looking at combinations and also moving into earlier lines. Those trials are getting started now, so they may be resulted in about five years or ten years, and we might start seeing them approved in earlier lines of indication also.
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