Related Experiment Video
Updated: Sep 24, 2025
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
BTK inhibitor selection for chronic lymphocytic leukemia: which drug for which patient?
Sai Prasad Desikan1, Sangeetha Venugopal1, Alessandra Ferrajoli1
1Departments of Leukemia, The University of Texas Houston, Texas, USA.
Introduction:
The development of BTK inhibitors has revolutionized the management of CLL. Currently, there are 3 BTK inhibitors available to treat CLL: ibrutinib, acalabrutinib, and zanubrutinib (the latter not yet approved for this disease but included in the NCCN guidelines). In this review, we will elucidate our approach to the selection of BTK inhibitor and provide insight into the future of BTK directed therapy.
Areas Covered:
This review utilizes data from published prospective trials, specifically RESONATE, RESONATE-2, ELEVATE-TN, ASCEND, ELEVATE-RR, and the ongoing FLAIR, SEQUOIA, and ALPINE trials.
Expert Opinion:
The choice of BTK inhibitor is guided by the setting (frontline vs relapsed) in conjunction with patient disease characteristics and comorbidities. In this review, we will elucidate our approach to the selection of BTK inhibitor and provide insight into the future of BTK directed therapy.
Insights
Choosing the right Bruton's tyrosine kinase (BTK) inhibitor for chronic lymphocytic leukemia (CLL) depends on patient factors and disease stage. This review guides BTK inhibitor selection and discusses future therapies.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Bruton's tyrosine kinase (BTK) inhibitors have transformed chronic lymphocytic leukemia (CLL) management.
- Several BTK inhibitors, including ibrutinib and acalabrutinib, are approved for CLL treatment, with zanubrutinib under consideration.
- NCCN guidelines incorporate BTK inhibitors for CLL therapy.
Purpose of the Study:
- To outline an approach for selecting the optimal BTK inhibitor for CLL patients.
- To provide insights into the evolving landscape of BTK-directed therapies for CLL.
Main Methods:
- Review of data from published prospective clinical trials.
- Inclusion of data from ongoing trials like FLAIR, SEQUOIA, and ALPINE.
- Analysis based on trial data including RESONATE, RESONATE-2, ELEVATE-TN, ASCEND, and ELEVATE-RR.
Main Results:
- BTK inhibitor selection is influenced by treatment setting (frontline vs. relapsed).
- Patient-specific disease characteristics and comorbidities are critical factors in decision-making.
- Current evidence supports the efficacy of available BTK inhibitors in CLL management.
Conclusions:
- A tailored approach to BTK inhibitor selection is essential for effective CLL treatment.
- Future directions in BTK-directed therapy hold promise for further improving patient outcomes.
- Personalized medicine strategies will likely play a greater role in CLL management with BTK inhibitors.
