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SOHO 2025 | BTK degraders in CLL: how may these agents shape the field?
Nirav Niranjan Shah, MD, Medical College of Wisconsin, Milwaukee, WI, shares his thoughts on the potential use of BTK degraders in the treatment of patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL), particularly those who have progressed on BTK inhibitors and venetoclax. He notes that future trials are needed to determine whether these agents provide a more effective way of targeting BTK compared to current methodologies. This interview took place at the 13th Annual Meeting of the Society of Hematologic Oncology (SOHO 2025) in Houston, TX.
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Transcript
Yeah, so I think, you know, initially, they’re going to be an option for those patients that have seen BTK inhibitors. And really, you know, that dual refractory, those who’ve seen venetoclax and a BTK inhibitor, so BCL2, BTKi, that is a population that is growing as these drugs get used more commonly. So then we need something for them when they progress on those agents. And I think BTK degraders are going to fit in initially in that third line setting as a treatment option, along with drugs like pirtobrutinib and CAR-T, but potentially a new, more powerful option, oral option, instead of something like CAR-T, which has its own risk profile...
Yeah, so I think, you know, initially, they’re going to be an option for those patients that have seen BTK inhibitors. And really, you know, that dual refractory, those who’ve seen venetoclax and a BTK inhibitor, so BCL2, BTKi, that is a population that is growing as these drugs get used more commonly. So then we need something for them when they progress on those agents. And I think BTK degraders are going to fit in initially in that third line setting as a treatment option, along with drugs like pirtobrutinib and CAR-T, but potentially a new, more powerful option, oral option, instead of something like CAR-T, which has its own risk profile. Over time, I would imagine they’re going to want to go up in line, and I look forward to them to do, I mean, I think the trial we need is a drug like bexobrutideg against zanubrutinib, against acalabrutinib, right? Because that’s how we answer the question about, you know, is this potentially a better way to target BTK than the current methodology that we have? Again, you know, unfortunately, these trials are going to take three to five years to be developed and mature. And, you know, I cannot speak for the company and what their timeline or study goals are, but I really hope that they move the trial forward given how excited we are right now in a late line setting.
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