CLL&nbsp;&nbsp;&nbsp;

How does pirtobrutinib compare to other available therapies for relapsed/refractory CLL after BTK inhibitor treatment, particularly in terms of efficacy and tolerability?

What post-protocol therapies did patients on the BRUIN trial in CLL receive, and how did these therapies impact outcomes?

How do CLL patients with downstream treatment-resistant mutations such as PLCG2 respond to pirtobrutinib?

Are there other mutations/biomarkers in CLL which may specifically predict for response or resistance to pirtobrutinib?

4 Answers available

How do you approach treatment for a fit patient with unmutated CLL who has progressed after BTKi and venetoclax containing regimens in the first and second line?

What is your approach to re-challenging BTK inhibitors for a patient who has had intolerance to several different agents?

Patient developed atrial fibrillation on Ibrutinib, severe fatigue and intolerance to Zanubrutinib and a maculopapular rash (grade 2) on Acalabrutinib

How has your approach to utilizing MRD-guided therapy in previously untreated CLL changed since the FLAIR trial, particularly in choosing between continuous versus time-limited treatment?

When would you use acalabrutinib in combination with obinutuzumab vs acalabrutinib alone in upfront CLL treatment?

What's the role of ibrutinib and venetoclax in CLL in light of data emerging from ASH 2022?

How do you approach CLL in a patient not currently on treatment who has a solid tumor that requires treatment?

Do you worry about their marrow reserve and response to neulasta in terms of lymphocytosis and decreased ANC response?

For CLL patients with high-risk cytogenetics on ibrutinib who develop a cardiac event such as an MI, would you continue ibrutinib?

Would you continue ibrutinib even if they are placed on anti-platelet therapy such as clopidogrel or ticagrelor? When do you switch to an altern...

5 Answers available

Would it be reasonable to offer a patient with CLL a treatment break from acalabrutinib or any BTK inihibitor after a period of time, assuming good response?

It is understood that the trial's experience was to keep on treatment indefinitely until progression or unacceptable toxicity. We are asking about rea...

How would you treat a fit patient with a history of relapsed CLL who now presents with Richter transformation s/p autologous anti-CD19 chimeric antigen receptor (CAR) T-cells?

What front line therapy would you recommend for a patient with CLL on chronic dual antiplatelet therapy?

How would your choice of therapy differ (if at all) for high vs low risk disease? Would the specific anti-platelet agents used influence your choice ...

What factors do you take into account for recommending venetoclax/obtinutuzumab vs BTK inhibitors vs chemotherapy in front line therapy for CLL?

Are there specific clinical, patient, or disease factors you focus on?

5 Answers available

Would you ever consider using ibrutinib in CLL patients who have received first line acalabrutinib and then progressed?

What is your preferred frontline treatment for CLL in young patients < 50 years old?

How do you utilize p53 NGS testing in your treatment planning for patients with CLL?

What VAF burden would be considered significant prognostically or for treatment decisions?

Would you continue venetoclax indefinitely/until disease progression in patients treated with upfront venetoclax for TP53 mutated CLL?

Would you extrapolate results from ELEVATE-RR study to favor use of acalabrutinib as first-line therapy in treatment-naive CLL?

Does this data change your preferred first line treatment regimens when considering other options such as mAb combos, cytotoxic chemotherapy?

Do you find ELEVATE-RR data and study design compelling to start preferentially using acalabrutinib over ibrutinib?

Is the non-inferiority margin of 1.429 sufficient, how was this selected? Is the open label (rather than blinded) study design of any concern? Is th...

4 Answers available

Do you routinely offer fungal prophylaxis for patients on BTK inhibitors?

Can experts comment on fungal pneumonia risk with individual BTK inhibitors as seen in ELEVATE-RR and whether this impacts their management decisions?

What is your approach to CLL in patients with atrial fibrillation and/or on anticoagulation?

Do you feel comfortable with BTK inhibitors in these patients? In ELEVATE-RR patients on a/c were excluded, and rate of atrial fibrillation in the ac...

Given results of the ELEVATE-RR study, would you consider use of acalabrutinib in all patients with previously treated CLL, or restrict it to certain patient populations?

Such as patients with specific underlying cardiovascular risk factors or other medical comorbidities?

For frail patients with cardiac co-morbidities and relapsed CLL with high cytogenetic risk, what are some considerations for using continuous acalabrutinib over fixed duration therapies such as venetoclax/rituximab?

What would be your choice of therapy in a fit patient with relapsed CLL previously treated with bendamustine and rituximab who does not want BTK inhibitor therapy?

Relapsed disease occurred 3.5 years after initial treatment

How would you treat a de novo CLL with WBC of 1,000,000 and no overt signs of leukostasis?

Do you ever discontinue ibrutinib in patients with CLL who have a good response?

For instance, would you discontinue when there is resolution of adenopathy and normalization of counts? If so, do you overlap ibrutinib with other the...