Chronic Lymphocytic Leukemia | Anthony R Mato, MD, MSCE

Chronic Lymphocytic Leukemia Update, Issue 1, 2019 — Part 2: Our most recent one-on-one interview with Dr Mato featuring emerging research and cases from his practice: Emerging data and recent advances in the management of CLL (00:00) Perspective on the role of MRD assessment in therapeutic decision-making (03:13) Duration of therapy for patients with CLL; integration of venetoclax into the treatment algorithm (05:44) Available data with the addition of rituximab or obinutuzumab to novel therapies (08:07) Selection of patients with CLL for treatment with FCR (fludarabine/cyclophosphamide/rituximab) (11:44) Novel combination approaches to limiting the duration of therapy for patients with CLL (13:36) Spectrum and incidence of toxicities with ibrutinib/venetoclax compared to either agent alone (15:41) Therapeutic options for patients with CLL in the first-line setting (17:55) Safety profile and quality of life with venetoclax versus ibrutinib (19:37) Frequency of and reasons for discontinuation of therapy with ibrutinib (22:37) Left atrial abnormality as a predictor of ibrutinib-associated atrial fibrillation in patients with CLL (24:48) Real-world outcomes and management strategies for patients with venetoclax-treated CLL in the United States (27:04) Experience conducting real-world outcome studies (29:06) Role of chemoimmunotherapy in the management of relapsed/refractory CLL (31:24) Clinical experience with and management of ibrutinib-associated adverse events (33:21) Investigation of ibrutinib in combination with CAR T-cell therapy for CLL (37:37) Case: A woman in her mid-70s with del(17p) CLL and no IGHV mutation experiences arthralgia and hypertension during second-line therapy with ibrutinib (40:53) Incidence and management of hypertension associated with ibrutinib (42:52) Dose reductions of ibrutinib to mitigate side effects; effect on efficacy (46:21) Case: A man in his mid-60s with a history of hypertension and atrial fibrillation receives acalabrutinib as first-line therapy for CLL (49:08) Headaches and hypertension associated with acalabrutinib (50:20) Comparative efficacy and spectrum of kinase activity with ibrutinib, acalabrutinib and zanubrutinib (52:38) Activity and tolerability of acalabrutinib versus ibrutinib (54:38) Case: A woman in her mid-50s with von Willebrand disease and CLL receives venetoclax after experiencing disease progression through several lines of therapy (56:58) Dose adjustments of venetoclax and management of TLS (1:01:18) Case: A woman in her late 80s with del(13q) CLL with IGHV mutation, symptomatic anemia and lymphadenopathy receives first-line obinutuzumab (1:04:19) Clinical experience with obinutuzumab-associated infusion-related reactions (1:06:26) Choice of first-line therapy for older patients with CLL (1:08:34) CME information and select publications