Symposium | Customizing first-line BTK inhibitors for CLL: Unmet needs with BTK inhibitors

During the Lymphoma Hub virtual symposium on October 23, 2024, entitled Customizing first-line Bruton‘s tyrosine kinase (BTK) inhibitors for chronic lymphocytic leukemia (CLL), Gilles Salles, Memorial Sloan Kettering Cancer Center, New York, US, delivered a presentation on the unmet needs with BTK inhibitors in CLL.

Salles provided an overview of the regulatory status of BTK inhibitors for the first-line treatment of CLL in the US and Europe, touching on the regulatory status of BTK inhibitors as monotherapy and in combination with other therapies, including rituximab, obinutuzumab, bendamustine, and obinutuzumab (Figure 1). Salles also discussed the National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) clinical guidelines for the first-line treatment of CLL (Figure 2).

Figure 1. An overview of the regulatory status of BTK inhibitors for first-line CLL* 

BTK, Bruton’s tyrosine kinase; CLL, chronic lymphocytic leukemia.
*Data from Ibrutinib FDA prescribing information¹, Ibrutinib EMA prescribing information², Acalabrutinib FDA prescribing information³, Acalabrutinib EMA prescribing information⁴, Zanubrutinib FDA prescribing information⁵, Zanubrutinib EMA prescribing information⁶, Pirtobrutinib FDA prescribing information⁷, ClinicalTrials.gov.^8,9
†Approved for adult patients with CLL who have received at least two prior lines of therapy, including a BTK inhibitor and a BCL-2 inhibitor.

Figure 1. Key guidelines for first-line treatment of CLL*  

CIT, chemoimmunotherapy; CLL, chronic lymphocytic leukemia; del, deletion; ESMO, European Society for Medical Oncology; FCR, fludarabine, cyclophosphamide, rituximab; IGHV, immunoglobulin heavy chain variable; NCCN, National Comprehensive Cancer Network.
*Data from National Comprehensive Cancer Network¹⁰ and Eichhorst et al.^11
†Ibrutinib + venetoclax changed from category 2B to category 2A in the October update.

Watch or download the presentation to learn more about:

• The regulatory status of BTK inhibitors for first-line CLL, including their approved combinations.
• The NCCN and ESMO guidelines for first-line CLL, including treatment options for fit or young patients, unfit or older patients, and patients with or without TP53^mut or del(17p).

This independent educational activity was supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. All content was developed independently by SES in collaboration with the faculty. The funder was allowed no influence on the content of this activity.