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iwCLL 2025 | Advice for community physicians managing patients with CLL
In this video, Alexey Danilov, MD, PhD, City of Hope, Duarte, CA, offers guidance to community physicians managing patients with chronic lymphocytic leukemia (CLL). Prof. Danilov highlights the importance of genetic profiling to identify genetic abnormalities, as they hold prognostic significance and can inform treatment decisions. He also emphasizes the importance of avoiding frequent therapy switches, as this can rapidly exhaust available treatment options. Additionally, he suggests that patients who progress on BTK inhibitors and venetoclax should be referred to a tertiary academic medical center to access novel agents and clinical trials.
This interview took place at the biennial International Workshop on Chronic Lymphocytic Leukemia (iwCLL) 2025 in Krakow, Poland. These works are owned by Magdalen Medical Publishing (MMP) and are protected by copyright laws and treaties around the world. All rights are reserved.
Transcript
So I think the first advice would be to test patients for genetic abnormalities because it does have prognostic significance and sometimes treatment choice may depend on it. Avoid chemotherapy at all costs. I know chemotherapy is still used in the community sometimes and we should really avoid it outside of very special circumstances. I think management of toxicities is something that communities are getting pretty used to with BTK inhibitors...
So I think the first advice would be to test patients for genetic abnormalities because it does have prognostic significance and sometimes treatment choice may depend on it. Avoid chemotherapy at all costs. I know chemotherapy is still used in the community sometimes and we should really avoid it outside of very special circumstances. I think management of toxicities is something that communities are getting pretty used to with BTK inhibitors. However, sometimes I still occasionally see that physicians who may have less experience get very trigger-happy to choose the drug – rather than try to mitigate the toxicity with the drug, they will try to switch the drug. It’s not always the right approach. You know, you can run out of options pretty quickly if you don’t do the right thing. And I think patients who progress on BTK inhibitors and venetoclax, they really need to see someone at a tertiary academic medical center to get the benefit of the trials with some of these novel exciting agents.
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Disclosures
Consulting Fees: Abbvie, ADCT, AstraZeneca, BeiGene, GenMab, Incyte, Janssen, Lilly Oncology, Merck, Nurix, Regeneron, Roche; Ongoing Research Funding: Beigene, GenMab, Incyte, Lilly Oncology, Merck, Nurix, Regeneron.
