Conference MDAngle: ASH 2024 Chronic Lymphocytic Leukemia

Conference MDAngle offers personal perspectives from conference attendees, showcasing their anticipation, quick takeaways, and insights into how the presented research will affect their patients.

The 2024 American Society of Hematology (ASH) Annual Meeting and Exposition was held in San Diego on December 7-10. Significant advancements in the treatment of chronic lymphocytic leukemia (CLL) were presented, highlighting a shift from traditional chemotherapy to targeted therapies. Presentations were given on targeted therapy combinations in the frontline treatment of CLL, particularly combinations of Bruton tyrosine kinase (BTK) inhibitors and BCL-2 inhibitors, such as pirtobrutinib, venetoclax, and obinutuzumab, sonrotoclax and zanubrutinib, and acalabrutinib and venetoclax. These approaches represent a significant advancement in personalized treatment strategies for CLL, aiming to enhance patient outcomes by tailoring therapy on the basis of individual disease progression.

Suchitra Sundaram, MD

Assistant Professor, Department of Hematology and Medical Oncology, Mount Sinai Icahn School of Medicine; Staff Physician, Department of Hematology and Medical Oncology, Mount Sinai Hospital, New York, NY

“The data from this ASH [meeting] demonstrate that we are on the brink of a transformative era in CLL, where fixed-duration combinations, new targeted therapies, and novel biomarkers are all working together to push further the boundaries of treatment in CLL.”

Preconference Considerations

ASH 2024: Awaiting Exciting Advancements in the Treatment of Chronic Lymphocytic Leukemia

Dr Sundaram reports on how ASH 2024 will showcase exciting advancements in CLL treatment, with a focus on targeted therapy combinations such as BTK inhibitors and BCL-2 inhibitors, as well as anti-CD20 monoclonal antibodies. Key presentations include the interim results from the phase 3 AMPLIFY trial and promising data on second-generation BTK inhibitors such as zanubrutinib and novel agents such as sonrotoclax. The meeting will also feature emerging therapies like BTK degraders and new insights into MRD-driven strategies, pushing the boundaries of personalized treatment for CLL.

Quick Clinical Takeaways

ASH 2024: Transformative Advances in CLL Treatment

Dr Sundaram highlights advances in CLL treatment at ASH 2024, including fixed-duration combinations such as acalabrutinib and venetoclax, which improved progression-free survival and allowed treatment de-escalation. Promising results for epcoritamab and emerging BTK degraders demonstrated efficacy in refractory and heavily pretreated patients, marking a shift toward more effective and targeted therapies.

How Will My Patients Benefit?

ASH 2024: The Clinical Impact of New CLL Data

Dr Sundaram describes how promising data for CLL treatment underscores the potential of MRD-guided therapy and all-oral combination regimens for her patients. A phase 2 trial showed that venetoclax-obinutuzumab duration could be tailored based on MRD status, offering durable remissions for MRD-undetectable patients. Additionally, the AMPLIFY phase 3 trial demonstrated that acalabrutinib and venetoclax significantly improved progression-free survival over chemoimmunotherapy, with the potential for FDA approval of this well-tolerated, time-limited, all-oral treatment.

Polling Question

Summary

Among the new CLL data presented at the 2024 ASH annual meeting, updates on MRD-driven strategies stood out, including tailored venetoclax-obinutuzumab durations, which showed potential for achieving durable remissions and highlighted a new era of precision medicine in CLL. Emerging therapies, such as second-generation BTK inhibitors such as zanubrutinib, novel agents such as sonrotoclax, and BTK degraders, also demonstrated efficacy in refractory and heavily pretreated patients.

In a series of three videos, Dr Suchitra Sundaram highlighted key advancements in CLL treatment, emphasizing a shift toward targeted therapy combinations and personalized strategies. Notable findings included interim results from the phase 3 AMPLIFY trial, in which acalabrutinib and venetoclax significantly improved progression-free survival compared with chemoimmunotherapy, offering a promising all-oral, fixed-duration treatment option.

Resources

Any views expressed above are the author's own and do not necessarily reflect the views of WebMD or Medscape.

Cite this: Conference MDAngle: ASH 2024 Chronic Lymphocytic Leukemia - Medscape - Nov 27, 2024.

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