Emily C. Ayers, MD, hematologist​/oncologist​, assistant professor, University of Virginia Health, discusses the evolving treatment landscape in chronic lymphocytic leukemia (CLL).

As the CLL space continues to shift away from us​ing traditional chemoimmunotherapy, targeted therapy ​has emerged as a standard treatment option, Ayers explains. The field is integrating tumor biology into the treatment selection process, with the goal of utilizing targeted therapies to obtain more durable responses, Ayers says.

Notably, the University of Virginia Health is currently participating in ongoing clinical trials that are evaluating the ​role of combination ​therapies in CLL. For example, the combination of ibrutinib (Imbruvica) and venetoclax (Venclexta) ​is being evaluated in the frontline setting for the treatment of patients with CLL. ​Combination regimens may allow patients​ to achieve deeper and more durable response​s; however, these trials will provide the field with critical insight, Ayers concludes.

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Emily C. Ayers, MD, hematologist​/oncologist​, assistant professor, University of Virginia Health, discusses the evolving treatment landscape in chronic lymphocytic leukemia.

Dr. Ayers on the Evolving Treatment Landscape in CLL

Emily C. Ayers, MD, a hematologist​/oncologist​ and an assistant professor at University of Virginia Health, discusses recent trials examining the use of venetoclax (Venclexta) in patients with chronic myeloid leukemia (CLL).

Several studies have taken place over the last few years examining the use of this agent, including the MURANO trial, Ayers says. In this trial, venetoclaxplus rituximab (Rituxan)was given to patients with relapsed/refractory disease and demonstrated benefit over chemotherapy.

In 2019, the CLL14 studyexaminedthe frontline combination of venetoxlax and obinutuzumab (Gazyva). Patients who were given the combination saw improvements in both progression-free survival and overall survival.

Emily C. Ayers, MD, discusses recent trials examining the use of venetoclax in patients with chronic lymphocytic leukemia. 

Dr. Ayers on Trials Examining Venetoclax in CLL

Emily C. Ayers, MD, a hematologist​/oncologist​ and an assistant professor at University of Virginia Health, discusses recent developments in chronic lymphocytic leukemia (CLL).

One development that has occurred within the past few years is fixed-duration therapy with venetoclax (Venclexta), in which patients receive treatment for 1-2 years depending on their line of therapy, Ayers explains. From there, patients can be monitored off treatment.

Testing for minimal residual disease (MRD) is another exciting advancement, although investigators are still working to fully understand the role of MRD in patients with CLL, Ayers says. While more research is needed, the field may be able to better identify patients who can be taken off treatment due to their deep, durable remissions, Ayers concludes.

Emily C. Ayers, MD, discusses recent developments in chronic lymphocytic leukemia.

Dr. Ayers on Recent Developments in CLL

Emily C. Ayers, MD, hematologist​/oncologist​, assistant professor, University of Virginia Health, discusses unmet needs in chronic lymphocytic leukemia (CLL).

Currently, CLL is an incurable disease, ​Ayers says. Although new therapies have prolonged survival for patients ​with CLL, additional therapies directed toward novel targets are needed in the relapsed/refractory setting because patients frequent​ly relapse and require multiple lines of therapy​.

In the past few years, several exciting developments​ have been made in CLL, including fixed-duration therapy with venetoclax (Venclexta)​, explains Ayers. With this regimen, patients receive treatment ​with venetoclax for ​1 to 2 years depending on the number of prior lines of therapy they ​have received. Once patients have completed the 1 to 2 years of treatment, they are closely monitored.

In terms of ongoing research, the role of minimal residual disease is under exploration​, says Ayers.

Looking forward, ​patients who achieve deep and durable remission ​may be able to discontinue therapy, Ayers concludes.

Emily C. Ayers, MD, discusses unmet needs in chronic lymphocytic leukemia. 

Emily C. Ayers, MD

Articles

Dr. Ayers on the Evolving Treatment Landscape in CLL

Dr. Ayers on Trials Examining Venetoclax in CLL

Dr. Ayers on Recent Developments in CLL

Dr. Ayers on Unmet Needs in CLL