The armamentarium of therapies available for our CLL patients has rapidly grown in recent years. As novel agents have become integrated into routine practice, navigating optimal use and sequencing of available options has become increasingly complex.
CARE™ Hematology Faculty lead, Dr. Peter Anglin (Stronach Regional Cancer Centre, ON), connected virtually with international expert Dr. John Seymour (Peter MacCallum Cancer Centre, Australia) to discuss how standards have evolved and considerations relevant to CLL treatment decisions in today’s landscape. Refer to the notes below the video stream for timestamps that can be used to navigate the questions that were covered.
To further illustrate how he is navigating sequencing in a real-world setting, Dr. Seymour also provided insight on a patient case provided by Dr. Anglin. The main discussion and a separate case review can be found below.
[Le contenu qui suit est présenté dans sa langue originale : Anglais]
Q1. What factors impact your choice of therapy in the frontline setting, and what is important to discuss with patients prior to making a treatment decision?
Q2. What has your experience been with initiating Ven treatment in clinic?
Q3. How important is time off therapy to patients?
Q4. What is your approach for high-risk patients upfront?
Q5. What do you consider when choosing therapy for patients who have relapsed after chemoimmunotherapy?
Q6. What is your approach for patients who have discontinued BTKi treatment due to side effects that cannot be managed?
Q7. What are your thoughts on Ven-monotherapy vs. Ven+R in patients who have progressed on BTKi’s?
Q8. Where are we headed with novel combinations upfront?
Q9. How do you determine risk when considering the Ven+R regimen?
Patient Profile: A 72-year-old female patient has progressed after being on Ibrutinib for 7 years. She has angina, good ventricular function, no rhythm problems, and is on a beta-blocker. She lives about a half-hour from the hospital and can drive. She is willing to take whatever treatment is suggested to her.
Q. What approach would you choose for this patient?