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Foreword – touchREVIEWS in Oncology & Haematology, Volume 22, Issue 1, 2026

This issue of touchREVIEWS in Oncology & Haematology brings together a diverse collection of articles reflecting the growing complexity of cancer care and the continued evolution of precision medicine across tumour types. From rare malignancies and treatment-related challenges to emerging targeted therapies and novel biological insights, the contributions highlight both recent progress and the significant […]

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touchFEATURE

BTK Inhibitors in CLL: Mechanisms and Management

Topics Covered:
Leukemia Hematology Hematologic Malignancies
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Understanding BTK Inhibitors in CLL

This video highlights the important distinction between how covalent and non-covalent BTK inhibitors bind in resistant CLL.

Material destinado exclusivamente a profissionais da saúde prescritores e dispensadores de medicamentos.
Material dirigido exclusivamente a profesionales de la salud.

MMAT-05326; MMAT-05013; MMAT-05070
July 2026, Eli Lilly and Company.

Clinical Decision Making in CLL: When to Stop and Start Treatment

This video explores CLL treatment decisions that balance efficacy and safety for patients.

Material destinado exclusivamente a profissionais da saúde prescritores e dispensadores de medicamentos.
Material dirigido exclusivamente a profesionales de la salud.

MMAT-05329; MMAT-05016; MMAT-05073
July 2026, Eli Lilly and Company.

Best Practices in Supportive Patient Care for CLL: Hypertension in Patients Treated with BTK Inhibitors

This video explains how to assess and manage hypertension risk in patients receiving BTK inhibitor treatment for CLL.

Material destinado exclusivamente a profissionais da saúde prescritores e dispensadores de medicamentos.
Material dirigido exclusivamente a profesionales de la salud.

MMAT-05327; MMAT-05014; MMAT-05071
July 2026, Eli Lilly and Company.

Best Practices in Supportive Patient Care for CLL: Infection and Vaccinations

This video provides key guidance for doctors on strategies to reduce infection risk in patients with CLL.

Material destinado exclusivamente a profissionais da saúde prescritores e dispensadores de medicamentos.
Material dirigido exclusivamente a profesionales de la salud.

MMAT-05328; MMAT-05015; MMAT-05072
July 2026, Eli Lilly and Company.

Videos

Understanding BTK Inhibitors in CLL

Duration: 1:20

Clinical Decision Making in CLL: When to Stop and Start Treatment

Duration: 2:05

Best Practices in Supportive Patient Care for CLL: Hypertension in Patients Treated with BTK Inhibitors

Duration: 1:10

Best Practices in Supportive Patient Care for CLL: Infection and Vaccinations

Duration: 1:09
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Videos

Understanding BTK Inhibitors in CLL

Duration: 1:20

Clinical Decision Making in CLL: When to Stop and Start Treatment

Duration: 2:05

Best Practices in Supportive Patient Care for CLL: Hypertension in Patients Treated with BTK Inhibitors

Duration: 1:10

Best Practices in Supportive Patient Care for CLL: Infection and Vaccinations

Duration: 1:09

Activity Overview

Overview

This four-part activity begins with Bruton tyrosine kinase (BTK) inhibitor use in chronic lymphocytic leukemia (CLL), a B cell malignancy with chronically activated BTK activity.1 Covalent BTK inhibitors form an irreversible bond with the C481 residue of BTK, resulting in sustained BTK blockade.2 However, the majority of patients who relapse on a covalent inhibitor harbour C481 mutations, the most common being C481S. Non-covalent BTK inhibitors do not bind to C481, thus overcoming this resistance and providing efficacy in CLL refractory to covalent inhibitors.3

Later modules turn to management. Patients with active CLL, as defined in guidelines,4 can be started on a BTK inhibitor, with decisions on both initiation and discontinuation dependent on maximising efficacy while minimising adverse events.5 Hypertension occurs in approximately a quarter of CLL patients initiated on a BTK inhibitor.6 While pre-existing hypertension does not preclude BTK inhibitor use, at-risk individuals should be monitored and treated, and dose reduction should be considered in those who develop high-grade hypertension.7

Infection is another important complication in CLL that warrants proactive management. Clinical strategies to avoid infection include recommended non-live vaccines as well as individualised prophylactic antimicrobial agents.

Learning Objectives

After watching this activity, participants should be better able to:

  • Describe the distinct mechanisms of action of covalent versus non-covalent BTK inhibitors
  • Identify key factors influencing the initiation, modification, and discontinuation of therapy in patients with CLL
  • Evaluate cardiac comorbidity to guide safe initiation of BTK inhibitor therapy
  • Identify evidence-based strategies to identify and mitigate the risks of infection in patients with CLL

References7

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1

Mouhssine S, Maher N, Matti BF, et al. Targeting BTK in B cell malignancies: From mode of action to resistance mechanisms. Int J Mol Sci. 2024;25.

2

Alsadhan A, Cheung J, Gulrajani M, et al. Pharmacodynamic analysis of BTK inhibition in patients with chronic lymphocytic leukemia treated with acalabrutinib. Clin Cancer Res. 2020;26:2800-9.

3

Gomez EB, Ebata K, Randeria HS, et al. Preclinical characterization of pirtobrutinib, a highly selective, noncovalent (reversible) BTK inhibitor. Blood. 2023;142:62-72.

4

Hallek M, Cheson BD, Catovsky D, et al. iwCLL guidelines for diagnosis, indications for treatment, response assessment, and supportive management of CLL. Blood. 2018;131:2745-60.

5

Molica S. Redefining efficacy and safety endpoints for chronic lymphocytic leukemia in the era of targeted therapy. Expert Rev Hematol. 2023;16:803-6.

6

Quartermaine C, Ghazi SM, Yasin A, et al. Cardiovascular toxicities of BTK Inhibitors in chronic lymphocytic leukemia: JACC: CardioOncology state-of-the-art review. JACC CardioOncol. 2023;5:570-90.

7

Awan FT, Addison D, Alfraih F, et al. International consensus statement on the management of cardiovascular risk of Bruton’s tyrosine kinase inhibitors in CLL. Blood Adv. 2022;6:5516-25.

Video Navigation

Videos

Understanding BTK Inhibitors in CLL

Duration: 1:20

Clinical Decision Making in CLL: When to Stop and Start Treatment

Duration: 2:05

Best Practices in Supportive Patient Care for CLL: Hypertension in Patients Treated with BTK Inhibitors

Duration: 1:10

Best Practices in Supportive Patient Care for CLL: Infection and Vaccinations

Duration: 1:09

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Eli Lilly and Company Ltd. provided financial support and content, and has had input into the detailed project scope. This activity is provided by touchMEDICAL for touchONCOLOGY.

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This activity has been funded by Eli Lilly and Company Ltd.

Eli Lilly and Company Ltd. provided financial support and content, and has had input into the detailed project scope. This activity is provided by touchMEDICAL for touchONCOLOGY.

No endorsement by Eli Lilly or touchMEDICAL of any unapproved products or unapproved uses is either made or implied by mention of these products or uses in touchMEDICAL activities. touchMEDICAL accepts no responsibility for errors or omissions.

This material is intended exclusively for healthcare professionals.
Material destinado exclusivamente a profissionais da saúde prescritores e dispensadores de medicamentos.
Material dirigido exclusivamente a profesionales de la salud.

MMAT-05343; MMAT-05362; MMAT-05087
Date of preparation: July 2026

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