VIDEO: New treatments in the pipeline for CLL

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There is some interest in terms of treatments that are available in other lymphoma realms that hopefully, will have some utility in CLL. We just talked about pirtobrutinib, which is, of course, available in mantle cell lymphoma. There's also CAR T-cell therapy, which is available in multiple types of lymphoma and we have seen, with reports on the TRANSFORM CLL trial, that although somewhat limited, there might be some activity and utility for CAR T for a select number of CLL patients. There's bispecific antibodies which are also approved for other lymphoma indications, and we are starting to get some early reports specifically with epcoritamab (Epkinly; Genmab, AbbVie) and its activity in CLL, so that's exciting. There are new targets that are being investigated like MALT1 inhibition, ROR1 inhibition are newer targets that I've seen some early phase reports of. So, those are certainly in the pipeline.

Also of interest is finding the best ways to utilize our currently-approved treatments and there has been and continue to be and will be for a long time, ongoing investigations in combining BTK with BCL2, and that was originally done with ibrutinib and venetoclax. We have ongoing studies with acalabrutinib and venetoclax, most notably the MAJIC study. And there's now a phase 3 that's going to open with zanubrutinib and their BCL2 inhibitors, sonrotoclax (BeiGene). So, BTK-BCL2 combinations are of interest in the first line setting certainly, but even in the relapse refractory setting, there's an ongoing study with pirtobrutinib and venetoclax as well. So, those are, I think, a lot of the pertinent trials and developments that are ongoing.