OnCo
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BTK inhibitor + venetoclax, fixed duration

Block the survival signal and remove the death shield at the same time, for about a year, then stop and stay in remission for years.

CAPTIVATE and GLOW (ibrutinib), AMPLIFY (acalabrutinib; FDA approved February 2026), SEQUOIA arm D (zanubrutinib), and CELESTIAL (sonrotoclax + zanubrutinib) all show high uMRD and durable PFS after 12-15 months of therapy. Fixed duration reduces cumulative toxicity and cost versus indefinite BTK inhibition.

Rationale
BTK inhibition mobilises CLL cells out of protective lymph-node niches and increases BCL-2 dependence; venetoclax then kills them. The two resistance mechanisms are independent.
Evidence
Multiple positive phase 3 trials; US approval 2026.

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