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Managed Care Cast

Managed Care Cast Presents: BTK Inhibitors in Treatment-Naive Patients With CLL and MCL

·33 min·3 clips
The AMPLIFI trial shows a 92% response rate for acalabrutinib and venetoclax, versus 75% for chemoimmunotherapy.
The episode begins with an introduction by Laura Jost, setting up a panel discussion moderated by Dr. Ryan Humschild with three oncologists. The conversation starts by outlining unmet needs in CLL and MCL, emphasizing personalized medicine and combination therapies. Dr. Graff provides an overview of emerging BTK inhibitor regimens, highlighting the AMPLIFI trial's 92% response rate for acalabrutinib and venetoclax compared to 75% for chemoimmunotherapy. She discusses other combinations like pertabrutinib with venetoclax and xanabrutinib with senrodoclax. The focus shifts to mantle cell lymphoma, where Dr. Graff mentions the ECHO trial adding acalabrutinib to bendamustine and rituximab, improving progression-free survival. Dr. Barrientos then addresses access challenges, noting the high cost of BTK inhibitors and issues with insurance coverage and prognostic marker testing. Dr. Davids explains factors in selecting between BTK inhibitors and venetoclax, such as comorbidities and patient preferences, and details choices between acalabrutinib and xanabrutinib based on side effects. The discussion covers treatment for aggressive MCL, prioritizing chemo-free options for high-risk patients with TP53 mutations. Dr. Barrientos discusses balancing clinical benefits with costs, including insurance policies and financial assistance programs. The Inflation Reduction Act is explored, with potential price negotiations for ibrutinib and out-of-pocket caps. Real-world evidence and patient-reported outcomes are mentioned as influencing clinical decisions. The episode concludes with thoughts on future research, including minimal residual disease testing and improving outcomes for high-risk patients.

As heard by us

A focused, technical review of how risk, comorbidities, cost, and preference shape BTK inhibitor decisions.

Treatment-naive CLL and MCL seldom fall into a neat treatment pathway, and this Managed Care Cast episode grounds that reality in decisions around BTK inhibitors.

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Why you'd press play

You want the clinical reasoning behind BTK inhibitor choices for treatment-naive CLL and MCL.

Read the full recommendation in PlayNext →
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