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ESH CLL 2026 | Continuous vs time-limited therapy in CLL: balancing efficacy and quality of life
Barbara Eichhorst, MD, University Hospital Cologne, Cologne, Germany, discusses treatment duration strategies in chronic lymphocytic leukemia (CLL), comparing continuous therapy with BTK inhibitors to time-limited regimens such as venetoclax-based combinations. She highlights the importance of balancing efficacy, quality of life, and infection risk when selecting treatment approaches. This interview took place at the ESH CLL 2026 congress in Stockholm, Sweden.
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Transcript
So with CC17 trial, which compared continuous treatment with ibrutinib versus ibrutinib venetoclax versus venetoclax plus obinutuzumab, at least after a relatively short follow-up of three years, there is no major difference. And we had also internally in our group, but also on a European level, long discussions, and there is a consensus that when we do see equal efficacy we would prefer the time-limited treatment because being off treatment and that’s what also patient representatives tell us is gained lifetime for them, time without side effects, and actually that’s what we observed also in our GAIA/CLL13 trial, where we administer different combinations of Venetoclax plus CD20 antibody, and actually we see here quite nicely how the quality of life is improving, in particular when patients finish treatment...
So with CC17 trial, which compared continuous treatment with ibrutinib versus ibrutinib venetoclax versus venetoclax plus obinutuzumab, at least after a relatively short follow-up of three years, there is no major difference. And we had also internally in our group, but also on a European level, long discussions, and there is a consensus that when we do see equal efficacy we would prefer the time-limited treatment because being off treatment and that’s what also patient representatives tell us is gained lifetime for them, time without side effects, and actually that’s what we observed also in our GAIA/CLL13 trial, where we administer different combinations of Venetoclax plus CD20 antibody, and actually we see here quite nicely how the quality of life is improving, in particular when patients finish treatment. And therefore, if we have similar efficacy, the preference would be towards time-limited treatment. And then we have different options of time-limited treatments using venetoclax plus CD20 antibody versus venetoclax plus ibrutinib or calabrutinib. I think here the decision right now should be made on a patient’s risk for infections. Some patients really have a high risk of infections where CD20 antibody may be problematic and we will see with longer follow-up of the subgroups, in particular if some patients, as patients with unmutated IGHV status, maybe benefit more from the combination of Venetoclax plus a BTK inhibitor.
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