Sequencing in Relapsed Refractory CLL

CME

Optimal Therapeutic Sequencing in Relapsed/Refractory CLL

Physicians: Maximum of 1.25 AMA PRA Category 1 Credits

Released: November 27, 2024

Expiration: May 26, 2025

Othman Al-Sawaf
Othman Al-Sawaf, MD
Farrukh T. Awan
Farrukh T. Awan, MD, MS, MBA
Alessandra Tedeschi
Alessandra Tedeschi, MD

Pretest

Progress
1 2 3
Course Completed
Please answer the questions below.
1.

Currently, how confident are you in your ability to plan optimal therapeutic strategies for patients with R/R CLL based on current guidelines, available clinical evidence, and expert recommendations?

2.

A patient with CLL with no TP53 mutation, no del(17p), and unmutated IGHV started treatment with ibrutinib but, after a period of benefit, experienced disease progression. Which of the following biomarker testing approaches would you recommend for this patient prior to choosing the next treatment?

3.

Case 4: Patient With PD After Venetoclax + Obinutuzumab and Acalabrutinib



  • Continuing with the patient from Case 3, the patient was treated with acalabrutinib after progressing following venetoclax + obinutuzumab

    • He tolerated continuous therapy well, but 2 yr later, he has slowly progressive symptomatic disease

    • His WBC count is 42 x 109/L, hemoglobin is 10.8 g/dL, and platelet count is 90 x 109/L

    • FISH panel shows del(11q) and no del(17p) or TP53 mutation; however, mutation testing reveals a BTK C481 mutation



In your current practice, what would you recommend for this patient?