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. 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: So, very personal question. Why can’t doctors start CLL treatment right away? Why put them on watch and wait?
Dr. Catherine Wu: That’s a great question. I think this is something that’s been studied for some time. I mean, there has long been a thought to do that, but there have actually been studies that showed that there wasn’t actually any clinical benefit to do it earlier. I think that one reason when we get to the genomics and start to study that CLL heterogeneity that I talked about before is that we still need to try to understand this better. But what we do know is that when we come in with something like a therapy, it actually changes the composition of the CLL. And so, it almost is a fuel to select for more resistant versions of the CLL.
So, the question kind of becomes like, “Do you want to start that process earlier or not?” That’s not to say that with the newer agent. On the other hand, the other side of that is treating earlier; shouldn’t it be better? And I think it will depend a little bit on what we’re treating with. So, if we have more tools, more drugs, better complementary ways to get at it from the very beginning, maybe that kind of selection won’t happen, but that’s to be seen.
