Joanna M. Rhodes, MD, MSCE

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.

Emerging Developments for the Treatment of R/R CLL

July 1st 2025

Panelists discuss how emerging therapies including BTK degraders, bispecific antibodies, and novel BCL-2 inhibitors represent exciting future treatment options for managing CLL patients across different lines of therapy.

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.

Bridging Strategies to CAR-T Therapy: Perspectives on Incorporating BTKi’s

June 24th 2025

Panelists discuss how bridging therapy with BTK inhibitors may optimize CAR T-cell outcomes by controlling bulky disease during manufacturing, with ibrutinib showing specific benefits for T-cell function enhancement.

Real-World Clinical Practice Insights from the TRANSCEND CLL004 Trial

June 24th 2025

Panelists discuss how lisocabtagene maraleucel (liso-cel) CAR T-cell therapy shows promise in heavily pretreated CLL patients, particularly younger patients with high-risk disease features who can achieve durable remissions.

Expert Insights on BRUIN CLL-321: Pirtobrutinib in BTKi Pretreated CLL Patients

June 17th 2025

Panelists discuss how the positive BRUIN CLL-321 phase 3 trial results support pirtobrutinib use after covalent BTK inhibitor exposure and consider its role in second-line versus third-line treatment sequencing.

Clinical Approaches in Switching Between BTKi’s in R/R CLL & Practical Considerations for Drug Holidays

June 17th 2025

Panelists discuss how clinical trial data supports switching between different covalent BTK inhibitors for intolerance management, with 60-70% of patients experiencing resolution of the original toxicity.

Identifying BTKi Treatment Intolerance in R/R CLL

June 10th 2025

Panelists discuss how to define true BTK inhibitor intolerance versus manageable side effects and describe successful strategies for switching between covalent BTK inhibitors to maintain treatment efficacy.

Considerations with Retreatment of Venetoclax-Containing Regimens

June 10th 2025

Panelists discuss how retreatment with venetoclax may be appropriate in certain scenarios despite prior exposure, though continuous BTK inhibitor therapy is often preferred for patients with high-risk disease features.

Clinical Perspectives: 59yF with R/R CLL Experiencing BTKi Treatment-Related AE

June 3rd 2025

Panelists discuss how to manage BTK inhibitor-related adverse events including atrial fibrillation, bleeding, and gastrointestinal toxicities through dose modifications, supportive care, and potential drug switching strategies.

Expert Perspectives: Sequencing Strategies after Acalabrutinib + Venetoclax +/- Obinutuzumab as First-Line Therapy in CLL

June 3rd 2025

Panelists discuss how sequencing therapies becomes challenging when using combination regimens like acalabrutinib-venetoclax in frontline treatment, requiring careful consideration of retreatment strategies and resistance mutation testing.

Timing of Treatment Initiation in Relapsed CLL: Factoring in Prognostic and Patient Factors

May 27th 2025

Panelists discuss how they approach prognostic marker testing at relapse, the importance of ruling out Richter's transformation, and timing of treatment initiation based on disease characteristics and progression patterns.

Clinical Perspectives: 59yF with R/R CLL after Time-Limited Therapy

May 27th 2025

Panelists discuss how a CLL patient with initially low-risk disease and mutated IGHV unexpectedly relapsed early after venetoclax-obinutuzumab treatment with acquisition of high-risk features, presenting unique management challenges.

Multidisciplinary Approach to Managing Treatment for Relapsed/Refractory CLL

November 26th 2024

Panelists discuss how their institutions organize multidisciplinary teams for chronic lymphocytic leukemia care, detailing the specific roles of various specialists including oncologists, nurses, pharmacists, and cardiologists in coordinating comprehensive patient care, managing adverse events, and addressing treatment-related complications throughout the course of therapy.

The Impact of Emerging Resistance Patterns on Treatment Sequencing in R/R CLL

November 26th 2024

Panelists discuss how emerging resistance patterns in chronic lymphocytic leukemia influence their approach to treatment sequencing, considering the mechanisms of resistance to different drug classes and how this knowledge informs the selection and order of therapies to maximize long-term disease control and patient outcomes.

Emerging role of doublet triplet therapies in R/R CLL: Expert Perspectives

November 19th 2024

Panelists discuss how they balance the potential benefits of aggressive first-line treatment in chronic lymphocytic leukemia against the importance of preserving effective options for subsequent lines of therapy, considering factors such as patient prognosis, treatment goals, and the evolving landscape of available therapies.