Callie Coombs, MD

Articles

Fixed-Duration vs Continuous Therapy—First-Line Choices in CLL

July 14th 2025

Panelists discuss how treatment selection between continuous Bruton tyrosine kinase (BTK) inhibitor therapy and fixed-duration regimens involves shared decision-making that weighs patient preferences for time investment, with continuous therapy requiring ongoing visits but offering potentially superior efficacy for high-risk patients, while acknowledging that indirect comparisons like the MAIC analysis comparing zanubrutinib-venetoclax with acalabrutinib-venetoclax provide additional evidence despite methodological limitations when head-to-head trials are not feasible.

Are Oral Fixed-Duration Doublets Right for High-Risk CLL?

July 14th 2025

Panelists discuss how oral fixed-duration Bruton tyrosine kinase (BTK) inhibitor–venetoclax doublets may be considered for patients with high-risk TP53-disrupted chronic lymphocytic leukemia (CLL) based on promising phase 2 data showing high undetectable minimal residual disease (MRD) rates, but express concerns about infection risks with triplet regimens and emphasize the need for longer follow-up data to determine durability of remissions, with some preferring MRD-guided longer duration approaches over standard 14-cycle regimens for these highest-risk patients.

Balancing Duration and Risk in First-Line Treatment Selection of CLL

July 7th 2025

Panelists discuss how determining the optimal duration for fixed-duration chronic lymphocytic leukemia (CLL) therapies requires balancing factors like disease burden, patient age, and IGHV mutation status, with current standard approaches being 12 cycles for venetoclax-obinutuzumab or 14 cycles for oral Bruton tyrosine kinase inhibitor–venetoclax combinations, while recognizing that patients with unmutated IGHV may need longer treatment despite having excellent outcomes even without achieving undetectable minimal residual disease.

SEQUOIA Arm D—Updated Data on Zanubrutinib Plus Venetoclax in Treatment-Naive Patients With CLL

July 7th 2025

Panelists discuss how the SEQUOIA Arm D study demonstrates that zanubrutinib plus venetoclax provides an effective all-oral doublet option for treatment-naive patients with chronic lymphocytic leukemia (CLL) including those with high-risk TP53 abnormalities, achieving 60% undetectable minimal residual disease rates regardless of TP53 status, although high-risk patients may require longer treatment duration than the standard 1-year fixed approach to reach optimal disease clearance.

Choosing the Right First-Line CLL Therapy—Patient Factors and Oral Fixed-Duration Doublets

June 30th 2025

Panelists discuss how first-line chronic lymphocytic leukemia (CLL) therapy selection balances prognostic testing results with individual patient factors, weighing continuous Bruton tyrosine kinase (BTK) inhibitor therapy vs fixed-duration venetoclax-based regimens based on patient preferences for pill vs infusion treatment, comorbidities like cardiac issues, and the emerging role of oral BTK inhibitor–venetoclax doublets for appropriate candidates.

Defining High-Risk Disease in CLL—Biomarkers and Baseline Testing

June 30th 2025

Panelists discuss how proper baseline testing, including cytogenetics, TP53 mutation status, and IGHV mutation testing, is essential for risk stratification and treatment selection in patients with chronic lymphocytic leukemia (CLL), with TP53 disruption being the most critical prognostic factor that typically directs clinicians toward continuous Bruton tyrosine kinase (BTK) inhibitor therapy.

Dr Coombs on Notable BTK Inhibitor Combination Studies in CLL

February 8th 2024

Callie Coombs, MD, discusses the investigation of notable BTK inhibitor combination trials in patients with chronic lymphocytic leukemia.

Dr Coombs on BTK Inhibitors and CAR T-Cell Therapy in CLL

July 14th 2023

Callie Coombs, MD, discusses treatment updates in patients with chronic lymphocytic leukemia.