This content is in French.
CLL: ESMO declares the end of chemotherapy, focus on targeted therapies
24 septembre 2025
By Lila Rouland | Published September 24, 2025 | 3 min read
#ChronicLymphocyticLeukemia #TargetedTherapies #ESMO
Clinicians had long debated: should high-risk CLL be treated earlier, even without symptoms? The idea was appealing—using targeted therapies at early stages to control the disease before it progresses. This was precisely tested in the CLL12 trial, which compared ibrutinib (a BTK inhibitor) with placebo in early-stage patients carrying poor-prognosis factors (unmutated IGHV, cytogenetic abnormalities). The outcome was clear: while ibrutinib delayed time to first treatment (progression-free survival), it offered no overall survival benefit.
Treating CLL too early exposes patients to adverse effects (hypertension, arrhythmias, bleeding) and the risk of resistance, without extending life. ESMO therefore maintains the “watch and wait” strategy: regular monitoring, with treatment only when the disease becomes active.
#ChronicLymphocyticLeukemia #TargetedTherapies #ESMO
Clinicians had long debated: should high-risk CLL be treated earlier, even without symptoms? The idea was appealing—using targeted therapies at early stages to control the disease before it progresses. This was precisely tested in the CLL12 trial, which compared ibrutinib (a BTK inhibitor) with placebo in early-stage patients carrying poor-prognosis factors (unmutated IGHV, cytogenetic abnormalities). The outcome was clear: while ibrutinib delayed time to first treatment (progression-free survival), it offered no overall survival benefit.
Treating CLL too early exposes patients to adverse effects (hypertension, arrhythmias, bleeding) and the risk of resistance, without extending life. ESMO therefore maintains the “watch and wait” strategy: regular monitoring, with treatment only when the disease becomes active.
Sign in to read the rest
Reserved for healthcare professionals, free registration.
Scientific reference
Eichhorst, B., et al. (2024). ESMO Clinical Practice Guideline interim update on new targeted therapies in the first line and at relapse of chronic lymphocytic leukaemia. Annals of Oncology, 35(9), 762–768.
View the source
