EHA 2019 | Relapsed CLL: treatment options in 2019
Peter Hillmen, MBChB, FRCP, FRCPath, PhD, of the University of Leeds, Leeds, UK, outline the treatment options available in 2019 to chronic lymphocytic leukemia (CLL) patients. This interview took place at the 24th Congress of the European Hematology Association (EHA) 2019, held in Amsterdam, Netherlands.
Transcript (edited for clarity)
In relapsed CLL there’s been a real increase, as in CLL generally, of available therapies. So I think we’ve now, in the last sort of two or three years, moved away from chemotherapy in relapsed disease and I can’t see a role ready for chemotherapy in relapsed CLL...
In relapsed CLL there’s been a real increase, as in CLL generally, of available therapies. So I think we’ve now, in the last sort of two or three years, moved away from chemotherapy in relapsed disease and I can’t see a role ready for chemotherapy in relapsed CLL. And the options really lie between a BTK-based therapy, or a venetoclax-based therapy.
I think with BTK, mainly ibrutinib at the moment, but there’s other drugs, second generation inhibitors coming along, such as acalabrutinib, the aim of therapy, right, is to control the disease. And we know that that strategy really leads to improved quality of life and also prolonged survival for the patients.
Although in relapsed disease patients, you know, some patients will become refractory to that approach. Whereas the venetoclax-based combinations lead to the eradication of detectable disease and a defined duration of treatment. So the MURANO study has clearly showing that the combination of venetoclax with rituximab leads to the majority of patients achieving MRD negative remissions, a defined duration of therapy of two years. And it’s clearly better than bendamustine-based chemoimmunotherapy.
So I think the choices in relapsed disease in CLL now really lie between ibrutinib and venetoclax plus rituximab.
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