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For patients with relapsed or refractory CLL, an expert explained that it’s important to understand the order of how treatments are given.
The treatment options and sequences in managing chronic lymphocytic leukemia (CLL) have changed over time, depending on prior therapy, especially for patients with relapsed or refractory disease.
Treatments for CLL, such as covalent Bruton’s tyrosine kinase (BTK) inhibitors and Bcl-2 inhibitors, are considered the “best agents,” Dr. John N. Allan said during an interview with CURE®.
Allan is an associate professor of clinical medicine at Weill Cornell Medicine in New York and recently presented at the 42nd Annual Chemotherapy Foundation Symposium (CFS) in New York.
Glossary
Relapse: the cancer returns after treatment previously worked.
Refractory: the cancer no longer responds to a specific treatment after having previously responded.
Covalent BTK inhibitor: an oral treatment that suppresses the BTK protein by forming a strong bond to it.
Bcl-2-based therapy: drugs that bind to the BCL2 protein, which prevent further growth of cancer, such as CLL.
However, for patients with relapsed or refractory CLL, options after these two treatments are necessary, he noted.
“If patients progress on a covalent, they can switch to a Bcl-2-based therapy,” Allan explained. “Likewise, a Bcl-2-based therapy, if used first, depends on how long of a remission patients might have had and whether or not to go to Bcl-2-based therapy again or a covalent BTK inhibitor.”
Allan sat down with CURE® to discuss why it’s important for patients to understand the sequences of treatment for managing relapsed or refractory CLL and how to advocate for potentially appropriate treatment options for themselves.
Transcript:
Obviously, these treatment approaches always have lots of pros and cons and very limited head-to-head data to identify which approach is best for a specific type of patient. So, patients speaking with their physician need to ask the appropriate questions, “Why is this best for me?”
Make sure that all options are, in fact, being explained in full, because it can be easy to focus on certain easier-to-implement therapies and not necessarily highlight more complicated scenarios such as CAR-T cells, clinical trials and even fixed-duration versus continuous therapy approaches. So, all of these questions need to be asked by the patient to make sure they understand all of the options that are available.
Transcript was edited for clarity and conciseness.
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