Brian T. Hill, MD, PhD, assistant professor, Hematology and Oncology, Cleveland Clinic, discusses the progression of treatment of patients with chronic lymphocytic leukemia (CLL).

Beyond the BTK inhibitors ibrutinib (Imbruvica) and acalabrutinib (Calquence), Hill says that recent data have shown potential for other agents in CLL. One of these agents is venetoclax (Venclexta), which demonstrated a survival advantage over bendamustine in patients with advanced CLL. Venetoclax is highly active, and with proper dose-escalation, Hill says that it can be safely administered without any real risk for tumor lysis syndrome.

In light of these results, Hill says that the days of chemotherapy as a treatment for patients with CLL are dwindling. Although, if chemotherapy is going to be used, it should only be used once. From there, clinicians should think about moving to the targeted agents that are available. Right now, BTK inhibitors are the go-to therapy for most patients.