Ongoing CLL Trials Most Likely to Change Clinical Practice

Jennifer Woyach, MD, associate professor at The Ohio State University, discusses current clinical trials going on in the chronic lymphocytic leukemia (CLL) space that are most likely to impact the treatment landscape at the American Society of Hematology Annual Meeting and Exposition being held December 7-10 in Orlando, Florida.

There’s a number of interesting ongoing studies in CLL right now. Many of them are designed to combine our most effective therapies with the goal of potentially creating a safe, time-limited, but also very effective therapy. I think some of the most interesting studies, and probably the most practice changing, are going to be the ones that are actually comparing that approach to standard of care.So 2 of the ones in the United States that are large phase 3 trials designed to encompass the entirety of the treatment-naïve CLL patient population are the EA9161 study, which is the new ECOG study, and A041702, which is the new ALLIANCE study. And both of these trials are comparing ibrutinib plus obinutuzumab versus the triplet of ibrutinib plus obinutuzumab plus venetoclax. They’re a little bit different in terms of what they do with patients after they finish that initial phase of therapy. So in the ECOG study, which is designed for younger patients, everybody completes about 18 months of therapy and then discontinues. In the ALLIANCE study, everybody completes about 12 months of therapy and then based upon their response, they’ll either continue ibrutinib or discontinue.Another study that isn’t ongoing just yet but will be coming soon is the CLL17 study, which is something by the German CLL Study Group. And that one is actually going to compare ibrutinib alone versus venetoclax plus obintuzumab versus ibrutinib plus venetoclax. That one obviously is going to take a long time to read out but really will give us our final answer on is it better to do the monotherapy BTK inhibitor, is it better to do it double without the BTK inhibitor or double with the BTK inhibitor.