Fludarabine, cyclophosphamide and rituximab (FCR) chemoimmunotherapy is the standard of care for the first-line treatment of young, fit patients with chronic lymphocytic leukemia (CLL). Trials have shown that the BTK inhibitor ibrutinib is effective in relapsed/refractory CLL and in older, untreated CLL patients relative to chlorambucil. However, it’s efficacy for the frontline treatment of younger CLL patients relative to the standard of care is unknown. Tait Shanafelt, MD, of Stanford University Medicine, Stanford, CA, presents the results of the Phase III ECOG-E1912 trial (NCT02048813) which investigated this very question. Speaking from the American Society of Hematology (ASH) 2018 Annual Meeting and Exposition in San Diego, CA, Dr Shanafelt highlights the exciting results, which have practice-changing implications.