Dr. Woyach on Treatment Challenges in CLL

Jennifer Woyach, MD, associate professor, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center—James, discusses current challenges in chronic lymphocytic leukemia (CLL) treatment.

One of the biggest challenges in CLL is deciding the best frontline therapy for each patient, explains Woyach. One study is performing a head-to-head comparison of ibrutinib (Imbruvica) with acalabrutinib (Calquence) in patients with relapsed, high-risk CLL. This trial completed enrollment within the last few years, and will hopefully read out in the next few years. If there are any efficacy and safety differences between ibrutinib and acalabrutinib, the results can likely be extrapolated to any setting, says Woyach.

Research is also investigating whether a single agent given sequentially or in combination therapy is better. Two studies through the National Comprehensive Cancer Network—1 is led by ECOG for patients <70 years old and 1 is led by ALLIANCE for patients who are ≥70 years old—are comparing ibrutinib plus obinutuzumab (Gazyva) versus ibrutinib/obintuzumab plus venetoclax (Venclexta). The purpose of these studies is to see whether adding venetoclax deepens the remission with ibrutinib-based therapies and allows for successful discontinuation of treatment, concludes Woyach.