Targeted Therapy and Role of Biomarkers in B-Cell Malignancies

This is a video synopsis/summary of an Insights featuring: Nicole Lamanna, MD.

Dr. Lamanna discusses recent advances in treatments for chronic lymphocytic leukemia (CLL) and the importance of prognostic testing. She notes over the past 5-10 years, Bruton tyrosine kinase (BTK) inhibitors like ibrutinib, acalabrutinib, and zanubrutinib as well as the B-cell lymphoma 2 (BCL2) inhibitor venetoclax have transformed CLL treatment and improved progression-free survival over chemoimmunotherapy regimens like FCR (fludarabine, cyclophosphamide, and rituximab) and BR (bendamustine and rituximab). These agents are given continuously until disease progression or intolerable side effects occur.

Dr. Lamanna still recommends checking prognostic markers like 11q deletion, 17p deletion/TP53 mutations, and complex karyotype at baseline and before each new line of therapy. While BTK and BCL2 inhibitors have improved outcomes even in traditionally high-risk patients, knowing prognostic factors provides insight on an individual’s disease and can influence regimen choice. For example, there are subtle differences in progression-free survival between regimens based on certain factors. Additionally, factors like IGHV mutation status do not change over time, while cytogenetic changes can emerge. Understanding a younger patient’s prognostic outlook is vital when considering their long-term treatment trajectory.

Video synopsis is AI-generated and reviewed by OncLive® editorial staff.