This video is an excerpt from CLL Global Research Foundation’s October 2025 Virtual Town Hall featuring CLL Global President, Dr. William Wierda, and Dr. Catherine Wu of Dana-Farber Cancer Institute. Watch the full town hall replay.
Expert Panel:
Dr. William Wierda, President & CEO, CLL Global Research Foundation
Dr. Catherine Wu, Chief in the Division of Transplant and Cellular Therapy, Dana-Farber Cancer Institute
Jeff Folloder, Moderator and CLL patient advocate
Transcript:
Jeff Folloder: Are there any new trials looking specifically at Richter’s?
Dr. William Wierda: There are interesting clinical trials. We’ve done a lot of work with chemoimmunotherapy. It does not work well for patients with Richter’s transformation, so we have turned our attention towards more immune-based treatments bispecific antibodies are being studied.
CAR T cells are being studied for patients with Richter’s transformation. And so, we will continue that work. We’re most optimistic about the immune-based strategies for patients with Richter’s. Even allogeneic stem cell transplant – that is the one situation where I will be more proactive about referring patients for a stem cell transplant if we can get control of their Richter’s transformation with treatments that we have, and they have a donor, and they’re fit enough to get a stem cell transplant.
So, this is an area that we’re doing a lot of work on. In order to conduct our clinical trials, we need referrals, and we need to be able to put patients on clinical trials, so we can do that with the patients that we follow closely here at our institutions of excellence. It would be helpful if we had more referrals from the community, if community physicians were referring us to those patients with Richter’s transformation specifically for our newer treatments and clinical trials. That would be helpful for us.
Jeff Folloder: Dr. Wu, would you like to add to that?
Dr. Catherine Wu: Yeah, I agree that it’s not the traditional treatments that we’ve been using that are working. You know, and ironically, there are some immunotherapies that don’t work in CLL, but appear to have a fighting chance in Richter’s. And I think there is some really interesting ongoing research that is beginning to delineate the differences in the immune microenvironment of CLL compared to Richter’s that might provide us with some answers as to why that is the case.
Dr. Wierda mentioned all these new bispecific antibodies that are kind of coming down the pike right now. These are being actively tested in Richter’s, and I think this is kind of an exciting new frontier, and we’ll see if we can see a lot of – see some success. My clinical area is an allogeneic stem cell transplant. And so, I am very cognizant of both the benefits, but also the toxicities that happen with transplant.
It’s really quite a blunt instrument. So, whatever we can do to keep the good parts and fend away the bad parts, I think would be beneficial. And fundamentally, allogeneic stem cell transplant is an immunotherapy. It is really trying to harness the donor immune system to eradicate leukemia cells. It comes with other attendant kinds of toxicities, but if you remember that aspect, then what is it about that immune response that was so important to get you to eliminate the leukemia? So, keep that part and try to build on it and make it less toxic, and I think that would be a path forward.
