Recent Developments in Chronic Lymphocytic Leukaemia Research: Interview with an Expert

Chronic lymphocytic leukaemia (CLL) is a common type of leukaemia with a variable clinical course. Effective targeted therapies for CLL in first-line and in relapsed or refractory disease include covalent Bruton tyrosine kinase inhibitors (BTKi), such as ibrutinib, acalabrutinib, and zanubrutinib; B cell leukaemia/lymphoma 2 (BCL2) inhibitors, such as venetoclax; and anti-CD20 monoclonal antibodies, such as obinutuzumab. Despite these treatments, the management of patients with CLL remains challenging. For this article, EMJ conducted an interview in January 2025 with expert Talha Munir from the Leeds Teaching Hospitals NHS Trust, UK, to raise awareness of CLL and discuss the highlights from the 66th American Society of Hematology (ASH) Annual Meeting and Exposition held in December 2024. Munir, who has a wealth of experience and expertise in the clinical management of CLL, provided valuable insights on the interim analysis results from the AMPLIFY study with acalabrutinib–venetoclax ± obinutuzumab (AV/AVO) versus fludarabine–cyclophosphamide–rituximab (FCR) or bendamustine–rituximab (BR); data at a median follow-up of 5 years from the SEQUOIA study with zanubrutinib versus BR; and updated data from the BRUIN CLL-321 study with the non-covalent BTKi, pirtobrutinib versus idelaslisib (a phosphoinositide 3-kinase inhibitor)–rituximab (IdelaR) or BR. Also explored were the implications and importance of BTK mutations in CLL, as well as emerging results for the BTK degraders, NX-5948 and BGB-16673, and the bispecific antibody, epcoritamab. The use of continuous therapy and fixed-duration therapy in clinical practice was also described. Finally, Munir outlined potential future developments in the CLL space, including the possibility of individualised therapy.