{"title":"Management of Relapsed and/or Refractory Chronic Lymphocytic Leukemia.","authors":"Allison Kagerer, Meghan C Thompson","doi":"10.1016/j.hoc.2025.05.008","DOIUrl":null,"url":null,"abstract":"<p><p>Covalent Bruton's tyrosine kinase inhibitors (cBTKis), including acalabrutinib and zanubrutinib, and the BCL2 inhibitor venetoclax are currently sequenced in both front-line and relapsed and/or refractory (R/R) chronic lymphocytic leukemia (CLL). A newer challenge is the management of patients with R/R CLL after exposure to both a cBTKi and BCL2 inhibitor. Herein, we review the management of R/R CLL following prior treatment with chemoimmunotherapy, cBTKi, and venetoclax-based therapy. We review treatment options for \"double exposed\" CLL including venetoclax retreatment, pirtobrutinib, and CAR T-cell therapy with lisocabtagene maraleucel. Emerging treatment options include agents in clinical trials such as BTK degraders and bispecific antibodies.</p>","PeriodicalId":55060,"journal":{"name":"Hematology-Oncology Clinics of North America","volume":" ","pages":""},"PeriodicalIF":2.7000,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Hematology-Oncology Clinics of North America","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.hoc.2025.05.008","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Covalent Bruton's tyrosine kinase inhibitors (cBTKis), including acalabrutinib and zanubrutinib, and the BCL2 inhibitor venetoclax are currently sequenced in both front-line and relapsed and/or refractory (R/R) chronic lymphocytic leukemia (CLL). A newer challenge is the management of patients with R/R CLL after exposure to both a cBTKi and BCL2 inhibitor. Herein, we review the management of R/R CLL following prior treatment with chemoimmunotherapy, cBTKi, and venetoclax-based therapy. We review treatment options for "double exposed" CLL including venetoclax retreatment, pirtobrutinib, and CAR T-cell therapy with lisocabtagene maraleucel. Emerging treatment options include agents in clinical trials such as BTK degraders and bispecific antibodies.
期刊介绍：
Hematology/Oncology Clinics updates you on the latest trends in patient management, keeps you up to date on the newest advances, and provides a sound basis for choosing treatment options. Under the direction of an experienced guest editor, each issue focuses on a single topic in hematology and oncology, including hemostasis and thrombosis, molecular and cellular basis of hematology, coagulation disorders, and cancers—bone, gastrointestinal, head and neck, lymphomas, neuroendocrine, breast, renal cell, melanoma, and more.
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