Individualizing 1L CLL Therapy

CME

Individualizing CLL Therapy: Frontline Treatment

Physicians: Maximum of 0.75 AMA PRA Category 1 Credit

Released: August 30, 2024

Expiration: August 29, 2025

Activity

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Introduction

In this activity, Jeremy S. Abramson, MD, MMSc; Farrukh Awan, MD; and Shuo Ma, MD, PhD, discuss factors in treatment decision-making for patients with chronic lymphocytic leukemia (CLL) who require first-line therapy.  

The key points discussed in this module are illustrated with thumbnails from the accompanying downloadable PowerPoint slideset, which can be found here or downloaded by clicking any of the slide thumbnails in the module alongside the expert commentary.  

Clinical Care Options plans to measure the educational impact of this activity. Some questions will be asked twice: once at the beginning of the activity and then once again after the discussion that informs the best choice. Your responses will be aggregated for analysis, and your specific responses will not be shared. 

Before continuing with this educational activity, please take a moment to answer the following questions.

How many people with CLL do you provide care for in a typical month?

A 74-year-old man with a long-standing history of hypertension, diabetes, and chronic kidney disease was diagnosed with CLL 5 years ago. He was managed with watchful waiting but now has progressive symptomatic lymphadenopathy. Scans revealed bulky abdominal and axillary nodes approximately 7 cm and splenomegaly of 17 cm. Bloodwork and prognostic workup revealed hemoglobin 9 mg/dL, platelet count 74000/µL, and white blood cell count 25,000/µL. FISH is positive for trisomy 12, TP53 wild-type, IGHV unmutated CLL, del(17p). He has difficulty with mobility due to arthritis and lives 2 hours from the treament center, so he hopes to minimize the amount of travel required for treatment.

Which of the following would you recommend as the best first-line therapy for this patient?

In the phase III ALPINE trial in previously treated CLL, which of the following adverse events showed a reduced incidence with zanubrutinib vs ibrutinib?

What is the duration of the ramp-up dosing schedule used when starting venetoclax to gradually reduce tumor burden and decrease the risk of tumor lysis syndrome?