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.