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Jan Joseph Melenhorst, PhD, discusses the evolving understanding of the use of CAR T-cell therapies in the treatment of patients with chronic lymphocytic leukemia.
Patients with chronic lymphocytic leukemia who experience disease progression during treatment with either covalent or noncovalent BTK inhibitors displayed a higher frequency of BTK mutations in L528W as well as RAS/RAF/MAPK pathway alterations, indicating that these alterations may play a role in the development of BTK inhibitor resistance.
Findings from the phase 1/2 BRUIN trial of show a distinct genetic evolution in patients with B-cell malignancies. However, the baseline BTK mutations did not impede pirtobrutinib’s effectiveness.
Patients with relapsed/refractory chronic lymphocytic leukemia achieved sustained progression-free survival and overall survival benefit after treatment with fixed-duration venetoclax plus rituximab vs bendamustine plus rituximab, according to data from the phase 3 MURANO trial.
The undetectable minimal residual disease ate achieved with bendamustine followed by obinutuzumab, acalabrutinib, and venetoclax increased as the regimen was continued as maintenance treatment in patients with relapsed or refractory chronic lymphocytic leukemia.