Danilov on BTK Inhibition for Relapsed/Refractory CLL

Alexey Danilov, MD, a hematologist oncologist at the City of Hope Comprehensive Cancer Center, discusses treatment options for relapsed/refractory chronic lymphocytic leukemia.

Alexey Danilov, MD, a hematologist oncologist at the City of Hope Comprehensive Cancer Center, discusses treatment options for relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL).

According to Danilov, very good results have been seen with Bruton’s tyrosine kinase (BTK) inhibitors, with some patients staying on them for 5-6 years before progression. This is true even in those with high-risk disease and in patients with TP53 mutations. In comparison, patients on chemoimmunotherapy tend to progress after a year.

BTK inhibitors help to delay when you have to being talking about R/R disease, says Danilov. However, questions still remain around progression in regard to BTK inhibitors. There are enough data on the use of second-line BTKs, according to Danilov. Additionally, if a patient progresses on the BCL-2 inhibitor, venetoclax (Venclexta), a BTK inhibitor may be a useful treatment option. In the case of progression on a BTK inhibitor, the reverse strategy of moving to a BCL-2 inhibitor is viable.