SOHO 2021 | Comparing BTK and BCL-2 inhibitor outcomes in different CLL subgroups

Nicole Lamanna, MD, Columbia University Medical Center, New York, NY, discusses clinical evidence relating to the treatment of chronic lymphocytic leukemia (CLL) with Bruton’s tyrosine kinase (BTK) inhibitors and BCL-2 inhibitors in older, treatment-naïve and younger patients. Dr Lamanna reports findings from the RESONATE-2 (NCT01722487) and ELEVATE CLL TN (NCT02475681) trials, highlighting the efficacy of BTK inhibitors in older, treatment-naïve patients. In the former trial, ibrutinib was superior to chlorambucil in terms of progression-free survival at a follow-up of seven years, whereas in the latter, acalabrutinib combination treatment was more efficacious than chlorambucil and obinutuzumab treatment. Additionally, evidence from the CLL14 trial (NCT02242942) suggests that a combination of the BCL-2 inhibitor venetoclax and obinutuzumab are effective in these patients. For younger patients who develop BTK-inhibitor-resistant mutations such as BTK C481S and PLCG2 mutations, venetoclax and the non-covalent BTK inhibitor pirtobrutinib may be effective. This interview took place during the ninth annual meeting of the Society of Hematologic Oncology (SOHO 2021) congress.