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ERIC CLL 2026 | Continuous acalabrutinib versus acalabrutinib plus venetoclax in del(17p) or TP53-mutated CLL
Marta Coscia, MD, PhD, University of Insubria, Varese, Italy, discusses the treatment approach for patients with chronic lymphocytic leukemia (CLL) with a del(17p) or a TP53 mutation. Prof. Coscia notes that the AMPLIFY trial (NCT03836261), which supported approval of the acalabrutinib-venetoclax combination, excluded patients with TP53 alterations; therefore, continuous treatment with a BTK inhibitor remains the preferred option. This interview took place at the 2026 ERIC International Meeting in Barcelona, Spain.
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Transcript
Actually in the frontline treatment of patients with TP53 aberration, the treatment guidelines still recommend to adopt a continuous treatment with a BTK inhibitor and therefore preferentially a second-generation BTK inhibitor such as acalabrutinib or zanubrutinib. The AMPLIFY study, which is the study that led to the approval of the combination of acalabrutinib plus venetoclax, were excluding from the enrollment patients with TP53 alterations...
Actually in the frontline treatment of patients with TP53 aberration, the treatment guidelines still recommend to adopt a continuous treatment with a BTK inhibitor and therefore preferentially a second-generation BTK inhibitor such as acalabrutinib or zanubrutinib. The AMPLIFY study, which is the study that led to the approval of the combination of acalabrutinib plus venetoclax, were excluding from the enrollment patients with TP53 alterations. So actually we don’t really have data showing the activity of this double combination in a patient with TP53 aberrations. And therefore, at least for, I mean, with the treatment schedule that we now have, which is a fixed duration treatment for 15 cycles. Therefore, I think that currently the best option based on the biology for this patient is still continuous treatment with a BTK inhibitor.
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