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EHA 2026 | Choosing between BTK inhibitors and fixed-duration therapy in frontline CLL
Dima El-Sharkawi, MB, BS, MA, PhD, MRCP, FRCPath, The Royal Marsden NHS Foundation Trust, London, UK, discusses how she approaches treatment selection for newly diagnosed patients with chronic lymphocytic leukemia (CLL). She reviews the key considerations when choosing between continuous BTK inhibitor therapy and fixed-duration venetoclax-obinutuzumab, emphasizing shared decision-making, treatment logistics, efficacy, and side-effect profiles. This interview took place at the 31st Congress of the European Hematology Association (EHA) in Stockholm, Sweden.
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Transcript
Discussions with newly diagnosed patients, often I talk about treatments being non-chemo-based now, that they’re a lot better than they used to be. If patients aren’t requiring therapy straight away, I don’t want to overwhelm them with lots of information on drugs, also because the landscape may change by the time they need treatment. So when patients are approaching therapy is generally the time that I start introducing the different choices of drugs...
Discussions with newly diagnosed patients, often I talk about treatments being non-chemo-based now, that they’re a lot better than they used to be. If patients aren’t requiring therapy straight away, I don’t want to overwhelm them with lots of information on drugs, also because the landscape may change by the time they need treatment. So when patients are approaching therapy is generally the time that I start introducing the different choices of drugs. And we do have very good continuous BTK inhibitor options for patients, but also very good fixed duration treatment options for patients. And the discussions about those different treatments can take a very long time and I often take it over a number of consultations to talk about the pros and cons of each. We talk about the logistics of delivery of these different treatment options, what the expected efficacy might be, and also the side effect profile for the different options. So when I’m factoring the treatment choice with the patient, I do discuss all those different elements with them. If there’s a particular preference that I have, I will say what my preferred choice is and my rationale for that. But I think those consultations with patients are becoming extremely more complex now with all the different choices that we have.
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