denotes an abstract that is clinically relevant.
denotes that this is a recommended PHD Trainee Session.
denotes that this is a ticketed session.Description:
Hematologists treating a patient with chronic lymphocytic leukemia (CLL) face the difficult task of choosing the most appropriate therapeutic regimen in a rapidly evolving field. There has been significant progress in the treatment of patients with CLL with improved knowledge of disease biology leading to the introduction of targeted agents and immunotherapies. While chemo-immunotherapy (CIT) regimens such as fludarabine-cyclophosphamide-rituximab (FCR) remain a reasonable treatment option for the frontline management of a young, fit patient with mutated IGHV without a 17p deletion or TP53 mutation, its use is decreasing due to the recent approval of several novel targeted drugs. The Bruton’s tyrosine kinase inhibitors (BTKi: ibrutinib and acalabrutinib) along with the BCL-2 inhibitor venetoclax are currently available for use in the frontline setting with or without the addition of a monoclonal antibody. These novel agents are becoming the preferred therapeutic interventions due to their remarkable efficacy, remission duration, and safety profile. With a growing armamentarium of available drugs, proper selection of the optimal treatment strategy is crucial to achieve long-term remissions.
Dr. Carol Moreno will outline the therapeutics available to treat patients with relapsed/refractory CLL after initial use of CIT and review the challenges of choosing the right regimen. She will highlight some of the key recent findings in relapsed CLL management strategies and discuss important selection factors in particular settings (high risk prognostic markers, comorbidities, fixed duration vs continuous duration).
Dr. Jacqueline Barrientos will discuss the challenge of selecting initial frontline therapy in a patient with CLL including optimized patient selection and toxicity mitigation. Using a case-based approach, Dr. Barrientos will suggest best practices in challenging cases due to comorbidities, side effects, and patient preference.
Dr. Anthony Mato will discuss and compare treatment strategies for patients requiring therapy after relapse following initial therapy with novel targeted agents with a review on current sequencing data post initial frontline therapy with novel agents. He will discuss different treatment approaches for a patient after the development of BTKi intolerance vs. true progression. Treatment recommendations based on clinical evidence and expert opinion will be reviewed for patients following discontinuation of venetoclax who progress while on therapy or relapse after fixed-duration regimen. He will also describe areas for future research.
Dr. Carol Moreno will outline the therapeutics available to treat patients with relapsed/refractory CLL after initial use of CIT and review the challenges of choosing the right regimen. She will highlight some of the key recent findings in relapsed CLL management strategies and discuss important selection factors in particular settings (high risk prognostic markers, comorbidities, fixed duration vs continuous duration).
Dr. Jacqueline Barrientos will discuss the challenge of selecting initial frontline therapy in a patient with CLL including optimized patient selection and toxicity mitigation. Using a case-based approach, Dr. Barrientos will suggest best practices in challenging cases due to comorbidities, side effects, and patient preference.
Dr. Anthony Mato will discuss and compare treatment strategies for patients requiring therapy after relapse following initial therapy with novel targeted agents with a review on current sequencing data post initial frontline therapy with novel agents. He will discuss different treatment approaches for a patient after the development of BTKi intolerance vs. true progression. Treatment recommendations based on clinical evidence and expert opinion will be reviewed for patients following discontinuation of venetoclax who progress while on therapy or relapse after fixed-duration regimen. He will also describe areas for future research.