What is your approach to utilizing MRD-guided therapy in previously untreated CLL, particularly in choosing between continuous versus time-limited treatment?

The question of what to do relative to a patient receiving therapy for CLL in first line and being MRD negative in blood/bone marrow with a reliable test (NGS sequencing or high sensitivity flow cytometry) and also no enlarged lymph nodes on CT/exam greater than 1.5 cm is challenging. For ibrutinib ...

MRD-guided therapies, including zanubrutinib with venetoclax per SEQUOIA Arm D and ibrutinib with venetoclax (per FLAIR), are highly effective, and SEQUOIA Arm D included patients with TP53-aberrant disease (unlike the AMPLIFY trial of fixed-duration acalabrutinib with venetoclax). The disadvantages...

From my standpoint, FLAIR has not changed how I utilize MRD. I predominantly use a highly sensitive flow cytometry approach at the end of therapy for patients not on a clinical trial. I do value the use of highly sensitive flow testing that can now get us close to 1 x 10 4 or even 10 5 leukemic cell...