Examining Safety and Efficacy of BTK Inhibitors In CLL and SLL Treatment

EP: 1.Clinical Characteristics Distinguishing CLL and SLL

EP: 2.Quality of Life Impacted By CLL and SLL Diagnosis and Management

EP: 3.Evaluating Current Treatment Landscape of CLL and SLL

EP: 4.Unmet Needs In CLL and SLL Treatment Management

EP: 5.Indications and Considerations For BTK Inhibitor Use In CLL and SLL Management

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EP: 6.Examining Safety and Efficacy of BTK Inhibitors In CLL and SLL Treatment

EP: 7.Determining Optimal CLL / SLL Therapy: Ibrutinib, Acalabrutinib and Zanubrutinib

EP: 8.Key Highlights From ASH 2023

EP: 9.Economic Burden Associated With BTK Inhibitor Use

EP: 10.Patient Education Driving BTK Inhibitor Treatment Adherence

EP: 11.Optimizing BTKi Treatment Strategies

EP: 12.Key Considerations for Treating Patients Diagnosed With CLL and SLL

This is a video synopsis/summary of a Peer Exchange involving Ryan Haumschild, PharmD, MS, MBA, CPEL; Tara Graff, DO, MS; Ryan Jacobs, MD; Deborah Stephens, DO; and Jennifer Woyach, MD.

The group discusses the lack of head-to-head trials comparing the next-generation Bruton tyrosine kinase (BTK) inhibitors acalabrutinib and zanubrutinib. Currently, the only comparative data come from trials in the relapsed/refractory setting. The ELEVATE-RR trial compared acalabrutinib withibrutinib and the ALPINE trial compared zanubrutinibwithibrutinib in relapsed/refractory chronic lymphocytic leukemia (CLL). These trials showed improved safety profiles with the next-generation BTK inhibitors, but they enrolled slightly different patient populations.

Without head-to-head data, providers must extrapolate the improved safety seen with next-generation BTK inhibitors in the relapsed setting into the frontline setting. Real-world evidence and matched-adjusted indirect comparisons can provide additional data but have limitations. Ultimately, providers may choose based on personal experience and subtle differences in adverseeffect profiles to best match the treatment to an individual patient. Having multiple next-generation options allows switching between covalent BTK inhibitors if a patient experiences intolerable adverseeffects while maintaining efficacy.

The National Comprehensive Cancer Network guidelines now list acalabrutinib and zanubrutinib as preferred frontline BTK inhibitor options over ibrutinib. More comparative data arestill needed, but the next-generation BTK inhibitors have established themselves as safer options than ibrutinib.

Video synopsis is AI-generated and reviewed by AJMC® editorial staff.