iwCLL 2025 | The evolving landscape of prognostic models in CLL

This is a very controversial issue because prognostic models are not used in the clinical practice, the routine clinical practice in CLL. However, if we consider different prognostic models that have been developed over the past time, probably CLL-IPI is the more popular. CLL-IPI was developed in the era of chemoimmunotherapy and so in the transition to the targeted therapy it was not able to retain its prognostic value. There is today a very, very interesting validation of CLL-IPI in the context of patients who were treated with targeted therapy. The results are interesting because they showed that progression through the CLL-IPI was able to accurately predict progression-free survival. However, if we consider overall survival, this predictive value was very low. What does it mean? It means that probably the overall survival of patients with CLL now improved and is approaching that of the age-matched population. So I think that today we need to look at different prognostic models, probably prognostic models that can be able to include together pre-treatment and post-treatment variables. And I think that a good candidate for being included as post-treatment variables are probably the evaluation of minimal residual disease and also the assessment of mutations for BTK and BCL2 inhibitors. So I think that probably is an area in a scenario which is developing. And another important thing is that we need to get those results over trials of combination therapy, BTK inhibitors plus BCL2 inhibitors with or without anti-CD20, because probably the results of this study when mature will mean will modify probably the algorithm, the algorithm that we use, we should use for developing the new models.

This transcript is AI-generated. While we strive for accuracy, please verify this copy with the video.