Margaret Krackeler, MD, hematologist/oncologist at Kaiser Permanente in Northern California, discusses how the practice has evolved its chronic lymphocytic leukemia (CLL) treatment algorithm, particularly the transition from ibrutinib to zanubrutinib among patients receiving Bruton tyrosine kinase (BTK) inhibitor therapy. TranscriptThis study captures a systemwide transition from ibrutinib to zanubrutinib in a real-world community oncology setting. In our study, patients switching to zanubrutinib had fewer treatment-limiting adverse events, as well as cardiac adverse events, and most of them, 79% of these patients, did remain on zanubrutinib at the last follow-up, without any treatment-related deaths. Looking at the patients who specifically had adverse events on ibrutinib, 17% of those patients ended up having a recurrence of those adverse events while on zanubrutinib, but there were low rates of treatment discontinuation of zanubrutinib with those adverse events. Real-world treatment patterns and outcomes of zanubrutinib in chronic lymphocytic leukemia and small lymphocytic leukemia (CLL/SLL).