‘Exciting’ New Therapies, Including BTK Inhibitors and Monoclonal Antibodies, Promising for CLL

How long responses last is still unclear

• Bruton’s tyrosine kinase (BTK) inhibitors need to be taken indefinitely
• The combination of a monoclonal antibody and venetoclax are also useful for prolonging remission
• Whether these drugs represent a cure is still unknown

In recent years, the treatment of chronic lymphocytic leukemia (CLL) has undergone a paradigm shift, with chemotherapy being replaced by a new and more effective generation of drugs. Among the “really exciting” therapies to emerge are the Bruton’s tyrosine kinase inhibitors, Dr. Julie Vose, chief of hematology/oncology at University of Nebraska Medical Center, tells SurvivorNet Connect.

However, one challenge with these drugs is that patients need to take them every day for the foreseeable future. “Once it’s stopped, unfortunately the CLL typically does come back,” Dr. Vose says.

The other non-chemotherapy development is the combination of the oral drug, venetoclax, with a monoclonal antibody such as rituximab or obinutuzumab that targets CD20, a protein that is expressed on most B-cell cancers. “Those can be very useful for a patient with CLL, to keep them in remission for a long time,” Dr. Vose adds. “They most likely are not a cure, but we don’t know that at this point. Patients do have to stay on the therapy for a while.” How long treatment needs to continue is currently the subject of clinical trials.