Dr Lindsey Roeker Outlines Unknowns Regarding Treatment Patterns in CLL

While there are more novel therapies available to treat chronic lymphocytic leukemia (CLL), there are still unanswered questions about how to use these therapies in sequences, said Lindsey Roeker, MD, clinical fellow at Memorial Sloan Kettering Cancer Center.

Transcript

What are some of the real-world unknowns regarding treatment patterns in CLL?

So, right now we have basically prospective data showing the efficacy of a lot of novel agents—which is fantastic. But how they work in sequences is still an unknown question. We have small numbers of patients that have been treated with a novel agent after a novel agent. So, venetoclax after ibrutinib, we know that works. But the converse, whether ibrutinib works after venetoclax is still somewhat of a question.

We have real-world data to support the use in people who have not previously been exposed to a BTK [Bruton tyrosine kinase] inhibitor, or for patients who have previously seen a BTK inhibitor but stopped because of intolerance. For patients who have actually previously failed a BTK inhibitor, it seems to be a less effective strategy.

But that’s all real-world data, retrospective. We don’t have a prospective, large data set to support that practice. So, I think that’s still a piece that we’re trying to figure out.