EXABS-179-CLL DEBATE: Sequencing Small Molecules Is the Way to Go

Sequencing and combination of currentsmall‐moleculeinhibitors for chronic lymphocytic leukemia: Where is the evidence?

“…In summary, sequential therapy is possible based on the durable response achieved in each class of small‐ molecule inhibitor and the option for retreatment with venetoclax‐based therapy 28 . Sequential therapy has also been postulated to result in fewer side effects in typical older CLL patients with comorbidities 37,89 . Many patients with CLL generally do not require more than one or two agents to keep their disease under control 49 .…”

“…28 Sequential therapy has also been postulated to result in fewer side effects in typical older CLL patients with comorbidities. 37,89 Many patients with CLL generally do not require more than one or two agents to keep their disease under control. 49 On the other hand, it is generally hypothesized that combination therapies may produce high response rates and MRD negativity, inferred from the achievement of MRD negativity in the ibrutinib-venetoclax combination for both fit and unfit individuals 90 and obinutuzumab-venetoclax combinations for unfit individuals.…”