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iwCLL 2025 | Optimizing frontline therapy in CLL: triplet regimens and testing for MRD
In this video, Barbara Eichhorst, MD, University Hospital Cologne, Cologne, Germany, comments on approaches being explored to optimize frontline therapy in chronic lymphocytic leukemia (CLL), highlighting the potential benefit of triplet regimens for patients with high-risk disease. Dr Eichhorst also discusses whether she believes measurable residual disease (MRD) testing should be performed in routine clinical practice. This interview took place at the biennial International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2025 in Krakow, Poland.
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Transcript
What we discussed this morning is also a lot about triplet treatment. We have seen that undetectable MRD rates are higher even when we look very deep for MRD and the data have been shown by Moritz Fürsteneau. On the other hand we know that the triplet has more side effects than a doublet regimen. However, there was some agreement that in particular very high risk CLL or higher risk CLL may benefit from a triplet regimen...
What we discussed this morning is also a lot about triplet treatment. We have seen that undetectable MRD rates are higher even when we look very deep for MRD and the data have been shown by Moritz Fürsteneau. On the other hand we know that the triplet has more side effects than a doublet regimen. However, there was some agreement that in particular very high risk CLL or higher risk CLL may benefit from a triplet regimen. And I think we will get more data on that during the next few years also with longer follow-up of Phase III studies as the AMPLIFY study, for example.
The other thing which was also discussed showing now what impact undetectable MRD has is when are we ready to test that in routine? I personally think we are not yet ready that this shouldn’t be recommended by guidelines. But certainly individually in some patients who want to know if with respect to the treatment-free interval duration, how good is my chance that I can be off treatment for a couple of years, it makes sense to test for MRD, because in the end it’s a similar or even better information than doing some imaging as a CT scan for example showing that there are no lymph nodes. So it’s similar showing that there was no detectable MRD, may have for the patient valuable information with respect to the time to the next treatment. However, we are not yet at the status where we should test for MRD by routine for, for example, prolongation of the treatment.
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