Dr. Byrd on Challenges Facing CLL

John C. Byrd, MD, D. Warren Brown Chair of Leukemia Research, professor of medicine, Medicinal Chemistry and Veterinary Biosciences, director, Division of Hematology, Department of Internal Medicine, The Ohio State University Wexner Medical Center, discusses the challenges facing the field of chronic lymphocytic leukemia (CLL).

The most challenging area for patients with CLL is when they develop resistance to BTK inhibitors or venetoclax (Venclexta), both of which are cross reactive, says Byrd. There are other small molecules that are coming down the pipeline that are going to be active in that setting. Those patients eventually have to go on to a transplant or chimeric antigen receptor (CAR) T-cell therapy.

Even in the targeted therapy era, physicians do not understand the biology of Richter’s transformation, which is a challenge, explains Byrd. Getting to the underpinning of what is causing it and either trying to prevent it, or use the vulnerability causing the transformation as a target for the drug. Physicians are working to create models where they can study that data and bring therapies forward.