Frontline therapy in Chronic Lymphocytic Leukemia

The treatment landscape of chronic lymphocytic leukemia (CLL) has tremendously evolved in the last decades thanks to the introduction of more effective therapies. Front-line therapy for patients with CLL includes chemoimmunotherapy (CIT) and pathway inhibitors (PI) (i.e., Bruton tyrosine kinase inhibitors and BCL2 inhibitors); the latter have proved to be more effective than CIT mainly in patients with high-risk features (eg, TP53 aberrations, unmutated IGHV) with acceptable toxicity. Combinations of PIs are playing a protagonist role as front-line therapy for CLL. In this article, the management of treatment- naive patients with CLL is discussed.