How does the speaker currently approach frontline use of pirtobrutinib in CLL?
They use it as their preferred frontline BTK inhibitor for most patients, because it was superior to ibrutinib in a randomized trial.
They limit it mainly to very unfit or frail patients, because it is not yet known whether acalabrutinib or zanubrutinib remain effective after resistance to pirtobrutinib develops.
They avoid it in the frontline setting because it has more side effects than the covalent BTK inhibitors.