President’s Corner

From time to time, Dr. Keating shares his reflections on the evolving landscape of CLL—offering perspective on progress, ongoing challenges, and where the field is headed.

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CLL – The New Era

G’day friends,

I’m writing to you once again from my home office, though I must admit, I still miss the daily interactions with colleagues and patients. Like many of you, I’ve adapted, and our conversations, now more often over video rather than coffee, continue to spark new ideas and direction.

These reflections have reinforced something I feel strongly: we are living in a new era of CLL.

Over the past 15 years, we have seen extraordinary advances in treatment—many made possible through the commitment of researchers and the generosity of supporters like you. Today, targeted therapies such as BTK inhibitors and BCL-2 inhibitors, along with emerging immune-based approaches, have transformed how we treat CLL. More patients than ever are achieving deep remissions, including undetectable minimal residual disease (MRD), and are living longer, fuller lives.

What’s New in CLL (2025–2026)

• Increased use of time-limited combination therapies (e.g., BTK + BCL-2 inhibitors)
• Growing role of MRD testing to guide treatment decisions
• Continued development of next-generation BTK inhibitors for patients with resistance or intolerance
• Expanding research in CAR T-cell therapy and bispecific antibodies
• Greater focus on early disease biology and prevention strategies

But as many of you know, the work is not finished.

There are still important challenges ahead. We must better understand—and overcome—treatment resistance that can develop over time. As our treatment options expand, we need clearer strategies to match the right therapy to the right patient at the right time, including how and when to use combination and time-limited approaches.

We must also address the immune dysfunction that affects many CLL patients, which can increase the risk of infections and second cancers. At the same time, advances in immune-based therapies—including CAR T-cell therapy and bispecific antibodies—offer exciting new opportunities to harness the immune system more effectively.

Richter’s transformation remains a serious complication, and we need better ways to identify patients at risk and more effective treatments for those who develop it. We are also learning more about the earliest stages of CLL, including monoclonal B-cell lymphocytosis (MBL), which may one day allow us to intervene earlier—or even prevent disease progression.

And ultimately, we must continue our pursuit of a cure.

The progress we’ve made is a direct result of a shared commitment—patients, families, scientists, and supporters working together toward a common goal. Your support plays an essential role in advancing the research that drives these breakthroughs.

When I look ahead, I am filled with optimism. The science is moving quickly, collaboration across institutions is stronger than ever, and the opportunities to make a lasting impact have never been greater.

We invite you to continue this journey with us.

Warm regards,
Michael Keating, M.B., B.S.
Founder, CLL Global Research Foundation