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The role of NGS in detecting resistance to targeted therapies in CLL

By Dylan Barrett

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Jun 26, 2026

Learning objective: After reading this article, learners will be able to discuss the utility of NGS in the management of patients wit CLL.


Do you know... What is a key clinical value of next-generation sequencing in CLL treated with targeted therapy?

Chronic lymphocytic leukemia (CLL) is increasingly treated with targeted agents such as BTK and BCL2 inhibitors, which have transformed outcomes but introduced new challenges related to acquired resistance. Resistance to targeted therapy can arise through multiple mechanisms, which often co-exist within an individual patient (Figure 1).¹ 

Figure 1. Genomic resistance mechanisms to targeted therapy in CLL*

Next‑generation sequencing (NGS) enables sensitive detection of these resistance-associated mutations, including low‑frequency variants that may emerge before clinical progression. Identification of these alterations can support clinical decision‑making by revealing emerging resistance pathways, informing treatment sequencing, and aiding interpretation of disease progression in patients receiving targeted therapy.1,2 

Here we present a visual abstract summarizing the role of NGS in detecting resistance mutations in CLL treated with targeted agents, drawing on recent evidence and expert perspectives.

Visual Abstract

To download this visual abstract, click below.

This educational resource is independently supported by Thermo Fisher Scientific. All content was developed by SES in collaboration with an expert steering committee. Funders are allowed no influence. 

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