Optimizing Treatment of Patients With Relapsed or Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma

Presented by:
Anthony Mato
Search for other papers by Anthony Mato in
Current site
Google Scholar
PubMed
Close
 MD, MSCE
Restricted access

Tremendous progress has been made in the treatment of relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) over the past few decades, starting with the development of glucocorticoids and alkylating agents, moving to combination chemotherapy, and then to chemoimmunotherapy. More recently, the advent of targeted agents has led to significant improvements in overall survival, progression-free survival, and quality of life. Most patients with R/R CLL and SLL are now treated with 1 of 5 approved targeted therapies rather than chemoimmunotherapy as standard of care. There are 2 main chemotherapy-free approaches in the R/R setting: Bruton’s tyrosine kinase inhibition and venetoclax-based therapy. Treatment after disease progression on first-line therapy depends on the initial choice of therapy, reason for discontinuation of prior lines of therapy, and available options.

Disclosures: Dr. Mato has disclosed receiving grant/research support and consulting fees from AbbVie, Inc., Acerta Pharma, Adaptive Biotechnologies, Johnson & Johnson, NURIX, GenMab, Genentech, Loxo Onocology, Inc., Pharmacyclics, Sunesis Pharmaceuticals, Inc., TG Therapeutics, Inc., and Zhejiang DTRM Biopharma Co. Ltd.; and serving as a scientific advisor for AbbVie, Inc., Acerta Pharma, Adaptive Biotechnologies, Celgene Corporation, Johnson & Johnson, Pharmacyclics, Sunesis Pharmaceuticals, Inc., TG Therapeutics, Inc., Verastem, Inc., and Zhejiang DTRM Biopharma Co. Ltd.

Correspondence: Anthony Mato, MD, MSCE, Memorial Sloan Kettering Cancer Center, 450 East 63rd Street, Apartment 4D, New York, NY 10065. Email: matoa@mskcc.org
  • Collapse
  • Expand
  • 1.

    Mato AR, Hill BT, Lamanna N, et al. Optimal sequencing of ibrutinib, idelalisib, and venetoclax in chronic lymphocytic leukemia: results from a multicenter study of 683 patients. Ann Oncol 2017;28: 10501056.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    Barr RM, Owen C, Robak T, et al. Up to seven years of follow-up in the RESONATE-2 study of first-line ibrutinib treatment for patients with chronic lymphocytic leukemia. J Clin Oncol 2021;39:7523.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3.

    Hillmen P, Eichhorst B, Brown JR, et al. First interim analysis of ALPINE study: results of a phase 3 randomized study of zanubrutinib vs ibrutinib in patients with relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma [abstract]. Presented at the 2021 European Hematology Association Annual Meeting; June 9–17, 2021. Abstract LB1900.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Hillmen P, Byrd JC, Ghia P, et al. First results of a head-to-head trial of acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia [abstract]. Presented at the 2021 European Hematology Association Annual Meeting; June 9–17, 2021. Abstract S145.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Rogers KA, Thompson PA, Allan JN, et al. Phase II study of acalabrutinib in ibrutinib-intolerant patients with relapsed/refractory chronic lymphocytic leukemia. Haematologica 2021;106:23642373.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6.

    Mato AR, Ghosh N, Schuster SJ, et al. Phase 2 study of the safety and efficacy of umbralisib in patients with CLL who are intolerant to BTK or PI3Kδ inhibitor therapy. Blood 2021;137: 28172826.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Kater AP, Kipps, TJ, Eichhorst B, et al. Five-year analysis of MURANO study demonstrates enduring undetectable minimal residual disease in a subset of relapsed/refractory chronic lymphocytic leukemia patients following fixed-duration venetoclax-rituximab therapy [abstract]. Presented at the 2020 ASH Annual Meeting & Exposition; December 5–8, 2020. Abstract 125.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Thompson MC, Allan JN, Sail K, et al. Venetoclax re-treatment of chronic lymphocytic leukemia patients after a previous venetoclax-based regimen. Blood 2020;136(Suppl 1):3941.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Mato AR, Roeker LE, Jacobs R, et al. Assessment of the efficacy of therapies following venetoclax discontinuation in CLL reveals BTK inhibition as an effective strategy. Clin Cancer Res 2020;26: 35893596.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Mato AR, Shah NN, Jurczak W, et al. Pirtobrutinib in relapsed or refractory B-cell malignancies (BRUIN): a phase 1/2 study. Lancet 2021;397:892901.

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 3085 412 105
PDF Downloads 1537 100 15
EPUB Downloads 0 0 0