Advancing CLL and MCL Care: The Impact of BTK Inhibitors in Treatment-Naive Patients and Emerging Therapies

Panelists discuss how, coming into ASH 2024, the largest unmet needs in the treatment and management of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) include improving outcomes for treatment-naive patients, with a focus on emerging Bruton tyrosine kinase inhibitor (BTKi) regimens such as acalabrutinib plus venetoclax, pirtobrutinib plus venetoclax, and zanubrutinib combinations.

Panelists discuss how the clinical implications of emerging Bruton tyrosine kinase inhibitor (BTKi) trials in chronic lymphocytic leukemia (CLL) are addressing unmet needs by offering new treatment options that target treatment-naive patients, potentially improving outcomes and filling gaps in the current therapeutic landscape.

Panelists discuss how emerging Bruton tyrosine kinase inhibitor (BTKi) treatment regimens for treatment-naive patients with mantle cell lymphoma (MCL), including acalabrutinib + bendamustine + rituximab (ECHO), acalabrutinib + lenalidomide + rituximab (ALR), acalabrutinib + umbralisib + ublituximab (AU2), ibrutinib + rituximab (ENRICH), and zanubrutinib + rituximab (CHESS), are exploring novel combinations to improve treatment outcomes and address unmet clinical needs in MCL therapy.

Panelists discuss how the clinical implications of emerging Bruton tyrosine kinase inhibitor (BTKi)trials in mantle cell lymphoma (MCL) are addressing unmet needs by providing novel therapeutic options, and explore how the integration of these therapies into current chronic lymphocytic leukemia (CLL) and MCL treatment guidelines could reshape management strategies, with consideration given to factors such as efficacy, safety, and patient access.

Panelists discuss how challenges in implementing emerging Bruton tyrosine kinase inhibitor (BTKi) regimens for treatment-naive patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) may include issues related to access, cost, and patient adherence, and highlight the need for ongoing research and collaboration to optimize BTKi use and improve patient outcomes in both diseases.

Panelists provide an overview of the current first-line treatment options for chronic lymphocytic leukemia (CLL), discussing the role of BTK inhibitors and venetoclax plus obinutuzumab (CLL14), and explore the continued role of ibrutinib in the CLL treatment landscape.

Panelists discuss the factors considered when selecting between BTK inhibitors and venetoclax plus obinutuzumab for chronic lymphocytic leukemia (CLL), the considerations for choosing among acalabrutinib, zanubrutinib, and ibrutinib, and the role of cytotoxic chemotherapy in the treatment of CLL in the era of targeted therapies.

Panelists discuss how therapy sequencing is approached for patients with chronic lymphocytic leukemia (CLL), with a focus on how prior therapy exposure influences the choice of subsequent treatments.

Panelists provide an overview of the current landscape of induction therapies for mantle cell lymphoma (MCL), discussing the role of Bruton tyrosine kinase (BTK) inhibitors in this setting and the use of aggressive induction therapies.

Panelists discuss the treatment- and patient-specific factors considered when determining induction therapy for treatment-naive patients with mantle cell lymphoma (MCL), including the decision between aggressive and less aggressive approaches, and how prior therapy exposure influences subsequent treatment sequencing for MCL.

Panelists discuss how patient-reported outcomes and real-world evidence influence clinical decision-making when selecting Bruton tyrosine kinase (BTK) inhibitors for the treatment of chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL).

Panelists discuss exciting updates on Bruton tyrosine kinase (BTK) inhibitors from the 2024 American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting emerging data that may refine their use in chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), particularly in optimizing treatment duration and sequencing to improve patient outcomes.

Panelists discuss how Bruton tyrosine kinase (BTK) inhibitors have transformed the treatment paradigm for patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), especially in the frontline setting, by offering effective, targeted therapy that provides significant clinical benefits and improves overall survival compared with traditional chemotherapy.

Panelists discuss how clinical and patient-specific factors, such as comorbidities, age, and risk profiles, influence the selection of Bruton tyrosine kinase (BTK) inhibitors for treatment-naive patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) while also considering how these factors align or differ from patient preferences regarding treatment duration, adverse effect profiles, and lifestyle impact.

Panelists discuss how they engage patients in shared decision-making by prioritizing open communication, discussing treatment options in the context of both clinical factors and patient preferences, and using strategies such as decision aids and detailed counseling to ensure that patient values and quality of life are fully integrated into the treatment planning process.

Panelists discuss proactive measures that health care teams can implement to manage adverse events associated with Bruton tyrosine kinase (BTK) inhibitors, such as early monitoring, dose adjustments, and supportive care, while emphasizing the importance of patient education to improve adherence and ensure positive treatment outcomes.

Panelists discuss challenges oncologists face in managing treatment-naive patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), including balancing efficacy with adverse effect profiles, and highlight strategies such as multidisciplinary collaboration and access to updated treatment guidelines to address these issues while also expressing eagerness for future advancements in Bruton tyrosine kinase (BTK) inhibitors and the need for further research to refine treatment strategies and improve patient outcomes.

Panelists discuss the primary access challenges in chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) treatment, including financial barriers and health care system limitations, and how these obstacles impact patient outcomes and treatment efficacy.

Panelists discuss how to balance the clinical benefits of Bruton tyrosine kinase (BTK) inhibitor therapies with their associated costs when making treatment decisions for chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), considering both patient outcomes and financial constraints.

Panelists discuss how the Inflation Reduction Act (IRA) might influence health care systems’ selection and utilization of Bruton tyrosine kinase (BTK) inhibitors, particularly through changes in pricing, reimbursement policies, and treatment access.

Panelists discuss how lower out-of-pocket costs resulting from ibrutinib’s inclusion in the Inflation Reduction Act (IRA) might improve the affordability and utilization of BTK inhibitor treatments in chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), potentially expanding access for patients.

Panelists discuss potential changes to clinical pathways for Bruton tyrosine kinase (BTK) inhibitor therapies as a result of the Inflation Reduction Act (IRA), focusing on how shifting costs and access regulations may impact treatment decisions and patient care strategies.

Panelists discuss the specific challenges and barriers clinicians might encounter when utilizing different BTK inhibitors under the regulations of the Inflation Reduction Act (IRA), including issues related to cost, access, and treatment guidelines.

Panelists discuss how payer policies and clinical pathways currently influence clinical decision-making for chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) treatments and explore strategies that managed care organizations can implement to control costs while ensuring patients have access to the most appropriate BTK inhibitor therapy.

Panelists discuss strategies and resources health care providers can offer to help alleviate the financial burden of long-term Bruton tyrosine kinase (BTK) inhibitor therapy for patients with chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL), focusing on support programs, cost-sharing solutions, and patient assistance initiatives.

Panelists discuss the future of Bruton tyrosine kinase (BTK) inhibitor therapies, considering emerging treatments, regulatory changes, evolving cost dynamics, and the current unmet needs in chronic lymphocytic leukemia (CLL) and mantle cell lymphoma (MCL) care, and how these factors may shape the landscape of treatment options.