Optimizing Risk Stratification and Subsequent Management of Chronic Lymphocytic Leukemia — Rapid Case Review: Microlearning Activity 2

Faculty

Faculty

Daniel Ermann

MD

Huntsman Cancer Institute at the University of Utah, Salt Lake City, Utah

Assistant Professor of Medicine, Department of Hematology and Hematologic Malignancies

Faculty

Shazia Nakhoda

MD

Fox Chase Cancer Center, Philadelphia, Pennsylvania

Assistant Professor in the Department of Hematology/Oncology

Faculty

Mazyar Shadman

MD, MPH

Fred Hutchinson Cancer Center and University of Washington, Seattle, Washington

Professor, Innovators Network Endowed Chair, Deputy Chief Medical Officer, Medical Director, Cellular Immunotherapy, Professor, Clinical Research Division

Faculty

Mahesh Swaminathan

MD, BS

The University of Texas MD Anderson Cancer Center, Houston, Texas

Assistant Professor, Department of Leukemia

TARGET AUDIENCE
This activity is intended for medical oncologists, hematology-oncology fellows and other healthcare providers involved in the treatment of chronic lymphocytic leukemia.

LEARNING OBJECTIVES

• Recognize the prognostic and clinical significance of various biomarkers (eg, del[17p], TP53 mutations, IGHV gene rearrangements) in chronic lymphocytic leukemia (CLL), and refine molecular testing algorithms for patients newly diagnosed with this disease.
• Individualize the selection of systemic therapy for patients with treatment-naïve CLL, considering new research findings, biomarker profile, clinical presentation, coexisting medical conditions and other factors.
• Appraise available Phase III data documenting the comparative efficacy and tolerability of first- and second-generation Bruton tyrosine kinase (BTK) inhibitors, and consider the implications of these findings for clinical decision-making for patients with newly diagnosed CLL, including those with high-risk features.
• Appreciate the scientific rationale for the investigation of combined Bruton tyrosine kinase and Bcl-2 inhibition, and review recently presented data documenting the safety and efficacy of this strategy for previously untreated CLL.
• Implement a plan of care to recognize and manage side effects and toxicities associated with available systemic therapies commonly employed in the management of newly diagnosed CLL.

ACCREDITATION STATEMENT
Research To Practice is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CREDIT DESIGNATION STATEMENT
Research To Practice designates this enduring material for a maximum of 0.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMERICAN BOARD OF INTERNAL MEDICINE (ABIM) — MAINTENANCE OF CERTIFICATION (MOC)
Successful completion of this CME activity, which includes participation in the evaluation component and a post-test, enables the participant to earn up to 0.75 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Please note, this program has been specifically designed for the following ABIM specialties: medical oncology and hematology.

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HOW TO USE THIS CME ACTIVITY
To receive credit for this activity, the participant should review the CME information, watch the video, complete the post-test with a score of 80% or better, and fill out the evaluation.

CONTENT VALIDATION AND DISCLOSURES
Research To Practice (RTP) is committed to providing its participants with high-quality, unbiased and state-of-the-art education and adheres to the ACCME’s Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of an accredited continuing education activity, including faculty, planners, reviewers and others, are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant financial relationships have been mitigated prior to the commencement of this activity. In addition, all activity content is reviewed by RTP scientific staff and an external, independent physician reviewer for fair balance, scientific objectivity of studies referenced and patient care recommendations.

FACULTY — The following faculty reported relevant financial relationships with ineligible entities:

Dr Shadman — Advisory Committees and Consulting Agreements: AbbVie Inc, ADC Therapeutics, Ascentage Pharma, AstraZeneca Pharmaceuticals LP, BeOne, Bristol Myers Squibb, Fate Therapeutics, Genentech, a member of the Roche Group, Genmab US Inc, Incyte Corporation, Janssen Biotech Inc, Kite, A Gilead Company, Lilly, Merck, MorphoSys, Nurix Therapeutics Inc, Pfizer Inc, Pierre Fabre; Contracted Research: AstraZeneca Pharmaceuticals LP, BeOne, Genentech, a member of the Roche Group, Genmab US Inc, Incyte Corporation, Janssen Biotech Inc, Merck, MorphoSys, Nurix Therapeutics Inc, Sana Biotechnology; Stock OPTIONS — Private Companies: Koi Biotherapeutics Inc; Nonrelevant Financial Relationships: Bristol Myers Squibb (spouse employment).

EDITOR — Dr Love is president and CEO of Research To Practice. Research To Practice receives funds in the form of educational grants to develop CME activities from the following companies: Aadi Bioscience, AbbVie Inc, ADC Therapeutics, Agendia Inc, Alexion Pharmaceuticals, Amgen Inc, Array BioPharma Inc, a subsidiary of Pfizer Inc, Arvinas, Astellas, AstraZeneca Pharmaceuticals LP, Aveo Pharmaceuticals, Bayer HealthCare Pharmaceuticals, BeOne, Biotheranostics Inc, A Hologic Company, Black Diamond Therapeutics Inc, Blueprint Medicines, Boehringer Ingelheim Pharmaceuticals Inc, Bristol Myers Squibb, Catalyst Pharmaceuticals Inc, Celcuity, Clovis Oncology, Coherus BioSciences, Corcept Therapeutics Inc, CTI BioPharma, a Sobi Company, Daiichi Sankyo Inc, Eisai Inc, Elevation Oncology Inc, Exact Sciences Corporation, Exelixis Inc, Genentech, a member of the Roche Group, Genmab US Inc, Geron Corporation, Gilead Sciences Inc, GSK, Helsinn Therapeutics (US) Inc, ImmunoGen Inc, Incyte Corporation, Ipsen Biopharmaceuticals Inc, Jazz Pharmaceuticals Inc, Johnson & Johnson, Karyopharm Therapeutics, Kite, A Gilead Company, Kura Oncology, Legend Biotech, Lilly, MEI Pharma Inc, Merck, Mersana Therapeutics Inc, Mirati Therapeutics Inc, Mural Oncology Inc, Natera Inc, Novartis, Novartis Pharmaceuticals Corporation on behalf of Advanced Accelerator Applications, Novocure Inc, Nuvalent, Nuvation Bio Inc, Pfizer Inc, Pharmacyclics LLC, an AbbVie Company, Puma Biotechnology Inc, Regeneron Pharmaceuticals Inc, Revolution Medicines Inc, Rigel Pharmaceuticals Inc, R-Pharm US, Sanofi, Seagen Inc, Servier Pharmaceuticals LLC, SpringWorks Therapeutics Inc, Stemline Therapeutics Inc, Sumitomo Pharma America, Summit Therapeutics, Syndax Pharmaceuticals, Taiho Oncology Inc, Takeda Pharmaceuticals USA Inc, TerSera Therapeutics LLC, Tesaro, A GSK Company, and Verastem Inc.

RESEARCH TO PRACTICE CME PLANNING COMMITTEE MEMBERS, STAFF AND REVIEWERS — Planners, scientific staff and independent reviewers for Research To Practice have no relevant financial relationships to disclose.

This educational activity contains discussion of published and/or investigational uses of agents that are not indicated by the Food and Drug Administration. Research To Practice does not recommend the use of any agent outside of the labeled indications. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings. The opinions expressed are those of the presenters and are not to be construed as those of the publisher or grantor.

This activity is supported by an educational grant from Boehringer Ingelheim Pharmaceuticals Inc.

Release date: July 2026
Expiration date: July 2027

After completing the post-test, learners may download and review the answers here in order to identify further areas of study.

Al-Sawaf O et al. Fixed-duration versus continuous treatment for chronic lymphocytic leukemia. N Engl J Med 2026;394(11):1084-96. Abstract

Al-Sawaf O et al. Fixed-duration versus continuous targeted treatment for previously untreated chronic lymphocytic leukemia: Results from the randomized CLL17 trial. ASH 2025;Abstract 1.

Ghia P et al. Impact of prognostic mutations on outcomes with fixed-duration acalabrutinib-venetoclax combinations versus chemoimmunotherapy: An exploratory analysis from AMPLIFY. ASH 2025;Abstract 3898.

Shadman M et al. An indirect comparison of zanubrutinib vs acalabrutinib plus venetoclax in patients with treatment-naïve CLL. Blood Adv 2026;10(8):2599-607. Abstract 

Shadman M et al. Zanubrutinib + venetoclax for treatment-naive chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), including patients with del(17p) and/or TP53 mutation and unmutated immunoglobulin heavy-chain variable status: 3-year results from SEQUOIA arm D. ASH 2025;Abstract 5669.

Swaminathan M et al. Addition of obinutuzumab after one year of combined acalabrutinib and venetoclax is safer and effective than early obinutuzumab in a randomized phase II trial for treatment naïve CLL. ASH 2025;Abstract 681.

Tam C et al. Frontline treatment of sonrotoclax (BGB-11417) and zanubrutinib for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) demonstrates high undetectable minimal residual disease (uMRD) rates with favorable tolerability: Updated data from BGB-11417-101, an ongoing phase 1/1b study. ASH 2025;Abstract 3891.

Woyach JA et al. Pirtobrutinib versus ibrutinib in treatment-naïve and relapsed/refractory chronic lymphocytic leukemia/small lymphocytic lymphoma. J Clin Oncol 2026;44(6):476-85. Abstract

Woyach JA et al. Pirtobrutinib vs ibrutinib in treatment-naïve and relapsed/refractory CLL/SLL: Results from the first randomized phase III study comparing a non-covalent and covalent BTK inhibitor. ASH 2025;Abstract 683.