Jennifer Brown, MD, PhD, director of the Chronic Lymphocytic Leukemia Center at Dana-Farber Cancer Institute, discussed the uptake of zanubrutinib for the treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL).
Jennifer Brown, MD, PhD, director of the Chronic Lymphocytic Leukemia Center and an institute physician at Dana-Farber Cancer Institute, discussed the uptake of zanubrutinib in chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL) following positive ALPINE trial (NCT03734016) results and the drug's full FDA approval for CLL and SLL in January 2023.1,2
Since the presentation of the ALPINE trial results in December 2023, what is your sense of uptake of zanubrutinib in first-line CLL/SLL?
I think it's slow but gradual and increasing, has been my experience, at least amongst academics and people who attend talks or who I interact with around the country. There has been less experience with zanubrutinib to date compared to acalabrutinib, and so many people are still using acalabrutinib and starting to dabble in zanubrutinib and moving over gradually.
Are patients encountering any barriers to testing needed for TP53 or 17p deletion?
No, I haven't really experienced any cost-related barriers, for example. We've been working on this for 15 years, and I think we have largely now reached a point where most patients in the community are at least getting their fish testing, [and] that includes 17p. There's still some lack of full awareness about doing TP53 mutation testing, as well. But we continue to discuss that, and it's certainly available.
In December, you said you didn’t see a reason to start patients on ibrutinib given the benefits seen in zanubrutinib. Do you hear from clinicians who have any issues access to zanubrutinib?
No, I haven't heard about any issues with accessing zanubrutinib. It is now fully approved in the United States for CLL in any line of therapy, and so we haven't had trouble getting it. Similarly, we don't have trouble getting acalabrutinib.
1. Brown JR, Eichhorst B, Hillmen P, et al. Zanubrutinib or ibrutinib in relapsed or refractory chronic lymphocytic leukemia. N Eng J Med. 2023; 388:319-332. doi:10.1056/NEJMoa2211582
2. FDA approves zanubrutinib for chronic lymphocytic leukemia or small lymphocytic lymphoma. News release. FDA. January 19, 2023. Accessed August 23, 2023. https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-zanubrutinib-chronic-lymphocytic-leukemia-or-small-lymphocytic-lymphoma