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ASH 2025 | Treatment options for patients with CLL who have developed resistance to covalent BTK inhibitors
In this video, Paolo Ghia, MD, Vita-Salute San Raffaele University, Milan, Italy, briefly discusses therapeutic options available for patients with chronic lymphocytic leukemia (CLL) who develop resistance to covalent BTK inhibitors, highlighting the recently approved non-covalent BTK inhibitor pirtobrutinib as a valuable option. This interview took place at the 67th ASH Annual Meeting and Exposition, held in Orlando, FL.
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Transcript
Yeah, that’s an evolving field. Very recently we had the approval of a novel drug, a non-covalent BTK inhibitor, pirtobrutinib, that can be used after failure with a covalent BTK inhibitor. And of course, we have also the other traditional option, which is the fixed duration treatment with venetoclax plus rituximab, venetoclax given for two years. So now we have one option, which is continuous treatment with pirtobrutinib or venetoclax plus rituximab...
Yeah, that’s an evolving field. Very recently we had the approval of a novel drug, a non-covalent BTK inhibitor, pirtobrutinib, that can be used after failure with a covalent BTK inhibitor. And of course, we have also the other traditional option, which is the fixed duration treatment with venetoclax plus rituximab, venetoclax given for two years. So now we have one option, which is continuous treatment with pirtobrutinib or venetoclax plus rituximab. And therefore, we probably have to accumulate more data to understand what’s the best sequencing. Though it’s likely, it’s possible that the patient will prefer to continue to exhaust somehow the BTK inhibition. So after failing on a covalent BTKi, it might be easier to transition them to a non-covalent BTKi because the way of administration of the drug is very similar, and therefore, somehow the patient will not even realize that they became resistant to a previous line of therapy.
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