Introductions & Framework for CLL Treatment

The moderator introduces the faculty panel, experts in the management of CLL, and outlines the session’s agenda, which centers on evolving frontline treatment strategies, sequencing considerations after relapse, and future directions. The panelists begin by grounding the discussion in the core principles that drive therapeutic decisions for newly diagnosed patients with CLL.

Early dialogue emphasizes the need to evaluate a combination of biologic, genetic, and patient-specific factors before initiating therapy. Clinicians describe how markers such as IGHV mutation status, TP53 disruption, cytogenetic risk features, and overall disease tempo shape initial treatment choices. They also highlight the importance of balancing efficacy with tolerability, particularly in older adults or those with comorbidities. Concepts of time-limited versus continuous therapy are introduced as a central theme.

The panel addresses the major frontline classes, including covalent BTK inhibitors (BTKis) and venetoclax-based regimens, discussing how each may be favored depending on the patient’s lifestyle, cardiovascular risk profile, and preference for daily therapy versus finite treatment. They note that as evidence accumulates, clinicians increasingly incorporate real-world experience to refine the selection of optimal first-line therapy. There is also reference to the declining role of chemoimmunotherapy, setting the stage for the deeper exploration that follows in later segments.

CLL is now treated with sophisticated targeted approaches that must be personalized. Understanding frontline decision-making is essential, as choices made at diagnosis strongly influence outcomes and available pathways for subsequent treatment lines.