Recognizing Unmet Need in the Era of Targeted Therapy for CLL/SLL: "What's Past is Prologue" (Shakespeare).

The management of CLL has undergone unprecedented changes over the last decade. Modern targeted therapies are incorporated into clinical practice. Unfortunately, patients have begun to develop resistance or intolerance to multiple classes. Symptomatic patients previously treated with a BTK inhibitor and venetoclax represent a new and rapidly growing unmet need in CLL. Here we define unmet needs in a modern treatment context. We also critically review the literature for PI3K inhibitors and chemoimmunotherapy and lack of data to support their utility following BTK inhibitors and venetoclax. Finally, we suggest opportunities to ensure the continued innovation for patients with CLL.