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Call to Action: Addressing Barriers to Optimal Management of Patients With Relapsed/Refractory CLL and MCL Using Innovative Therapies

Clinical Thought

In this commentary, I discuss the essential need to ensure that all eligible patients with relapsed/refractory CLL and MCL have access to innovative treatment options and some key points for healthcare professionals to remember in providing optimal treatment for these patients.

Physician Assistants/Physician Associates: 0.25 AAPA Category 1 CME credit

Pharmacists: 0.25 contact hour (0.025 CEUs)

Nurses: 0.25 Nursing contact hour

Physicians: Maximum of 0.25 AMA PRA Category 1 Credit

Released: September 13, 2023

Expiration: September 12, 2024



Farrukh Awan

Farrukh Awan, MD, MS, MBA

Professor of Internal Medicine
Director of Lymphoid Malignancies Program
Harold C. Simmons Comprehensive Cancer Center
University of Texas Southwestern Medical Center
Dallas, Texas

Provided by

Provided by Clinical Care Options, LLC

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This activity is supported by an educational grant from Lilly.


Target Audience

This program is intended for hematologists, medical oncologists, nurse practitioners, physician associates/physician assistants, pharmacists, nurses, and other healthcare professionals who care for patients with CLL/SLL or MCL.

Program Learning Goal

The goal of this program is to improve the knowledge, competence, and performance of learners to optimize treatment with BTK inhibitors in caring for patients with relapsed/refractory CLL/SLL and relapsed/refractory MCL.

Learning Objectives

  • Evaluate differences between covalent and noncovalent BTKi in terms of molecular characteristics, selectivity, clinical data, approved indications, dosing, safety profiles, and efficacy and their respective impact on clinical practice

  • Plan BTKi-based therapeutic strategies for patients with R/R CLL/SLL or R/R MCL, taking into consideration current indications, expert and guideline recommendations, and recent practice-changing clinical trial evidence

  • Implement evidence-based therapy for patients with resistance to or intolerance of covalent BTKi-based therapy to optimize clinical outcomes

  • Optimally manage adverse events associated with BTKi-based therapies considering safety profiles unique to each agent and regimen

  • Identify patients with R/R MCL and R/R SLL/SLL who may be eligible for ongoing clinical trials evaluating currently available and emerging BTKis and BTKi-based combinations


Clinical Care Options, LLC (CCO) requires instructors, planners, managers, and other individuals who are in a position to control the content of this activity to disclose all financial conflicts of interest (COI) they may have with ineligible companies. All relevant COI are thoroughly vetted and mitigated according to CCO policy. CCO is committed to providing its learners with high-quality CME/CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.

The faculty reported the following relevant financial relationships or relationships to products or devices they have with ineligible companies related to the content of this educational activity:

Primary Author

Farrukh Awan, MD, MS, MBA

Professor of Internal Medicine
Director of Lymphoid Malignancies Program
Harold C. Simmons Comprehensive Cancer Center
University of Texas Southwestern Medical Center
Dallas, Texas

Farrukh Awan, MD, MS, MBA: consultant/advisor/speaker: AbbVie, Adaptive Biotechnologies, ADC Therapeutics, AstraZeneca, BeiGene, Bristol Myers Squibb, Caribou Biosciences, Dava Oncology, Genmab, Incyte, Kite Pharma, Loxo Oncology; researcher: AbbVie/Pharmacyclics.

The planners and content peer reviewers from Clinical Care Options, LLC do not have any relevant financial relationships to disclose, except Kristi K. Orbaugh and Susan J. Moench, as noted below.

Kristi K. Orbaugh, MCN, NP, AOCNP: consultant/advisor/speaker: AstraZeneca, Bristol-Myers Squibb, CTI, DSI, Gilead, Lilly, MorphoSys, Pfizer.

Susan J. Moench, PhD, PA-C: independent contractor: Gilead, Merck.

Instructions for Credit

Participation in this self-study activity should be completed in approximately 0.25 hours. To successfully complete this activity and receive credit, learners must follow these steps during the period from September 13, 2023, through September 12, 2024:

  1. Login or Sign Up for an account by clicking at the top of this page
  2. Read the target audience, learning objectives, and faculty disclosures
  3. View and study the content in its entirety
  4. Submit answers to the evaluation questions online

You must respond to all evaluation questions to receive a certificate. After submitting the evaluation, you may access your online certificate by clicking the certificate link on the confirmation page. Records of all CME/CE activities completed can be found on the "My Certificates" page. There are no costs/fees for this activity.


This program has been made available online.

Disclosure of Unlabeled Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.


Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.


Joint Accreditation Statement

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In support of improving patient care, Clinical Care Options, LLC (CCO) is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team. 

Physician Continuing Medical Education

CCO designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Nursing Continuing Professional Development

The maximum number of hours awarded for this Nursing Continuing Professional Development activity is 0.25 contact hours.

Continuing Pharmacy Education

CCO designates this continuing education activity for 0.25 contact hours (0.025 CEUs) of the Accreditation Council for Pharmacy Education. Universal Activity Number - JA4008176-0000-23-240-H01-P 

Type of Activity: Knowledge

Upon successfully completing the post-test with a score of or better and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 60 days.

Physician Associate Continuing Medical Education

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Clinical Care Options, LLC has been authorized by the American Academy of PAs (AAPA) to award AAPA Category 1 CME credit for activities planned in accordance with AAPA CME Criteria. This activity is designated for 0.25 AAPA Category 1 CME credits. Approval is valid until September 12, 2024. PAs should only claim credit commensurate with the extent of their participation