{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:18:23Z","timestamp":1783012703109,"version":"3.54.6"},"reference-count":23,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T00:00:00Z","timestamp":1776038400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European J of Haematology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Optimal patient selection for the most effective BTK inhibitor (BTKi) partner of venetoclax in fixed\u2010duration (FD) BTKi\u2013venetoclax regimens for chronic lymphocytic leukemia (CLL) remains uncertain. This uncertainty largely reflects trial populations that are younger and fitter than many real\u2010world patients, which may limit generalizability to older individuals or those with multiple comorbidities. The present study aims to provide harmonized, pragmatic guidance that bridges trial evidence and routine clinical practice for physicians caring for patients within a regional Italian area served by an established CLL network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An adapted Delphi process engaged nine hematologists from Campania, a Southern Italian region, to evaluate the impact of BTKi\u2013venetoclax upfront decision making on three key CLL decision domains: (1) specific comorbidities, (2) genomics (TP53\/del(17p), IGHV status, complex karyotype), and (3) logistics (caregiver support, distance to center, and venetoclax ramp\u2010up capacity). A preregistered systematic literature review (2014\u20132025) informed 12 statements, with consensus defined as \u2265\u200975% agreement. The two\u2010round Delphi included structured discussion and anonymous voting. Additionally, artificial intelligence (AI) benchmarking with ChatGPT\u20104 assessed concordance with evidence briefs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Consensus was achieved on 83.3% of statements. The panel recommended FD BTKi\u2013venetoclax regimens for fit, younger patients with low\u2010 or intermediate\u2010genomic risk. For patients with low\u2010intermediate cardiovascular risk, continuous second\u2010generation BTKi monotherapy or FD therapy combining a second\u2010generation BTKi acalabrutinib with venetoclax is preferable to FD ibrutinib\u2013venetoclax. Adverse genomic features and logistical challenges were key factors favoring continuous second\u2010generation BTKi therapy. AI benchmarking indicated potential for hybrid human\u2013AI decision support, although concordance was fair (58.3%; Cohen's\n                      <jats:italic>\u03ba<\/jats:italic>\n                      \u2009=\u20090.32).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study provides a pragmatic, consensus\u2010driven framework for FD BTKi\u2013venetoclax therapy in CLL, emphasizing patient selection and logistical feasibility. The work lays the groundwork for more rigorous evaluation of human\u2013AI collaboration in the still\u2010complex landscape of first\u2010line CLL therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ejh.70195","type":"journal-article","created":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T01:34:10Z","timestamp":1776130450000},"page":"366-374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Bridging Trials and Real Life in Fixed\u2010Duration\n                    <scp>BTKi<\/scp>\n                    \u2013Venetoclax for\n                    <scp>CLL<\/scp>\n                    : A Delphi\u2010Enhanced Synthesis Incorporating Artificial Intelligence (\n                    <scp>AI<\/scp>\n                    ) Benchmarks"],"prefix":"10.1111","volume":"117","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2795-6507","authenticated-orcid":false,"given":"Stefano","family":"Molica","sequence":"first","affiliation":[{"name":"Department of Hematology Hull University Teaching Hospitals NHS Trust  Hull UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariano","family":"Lucignano","sequence":"additional","affiliation":[{"name":"Hematology Department General Hospital Tortora  Pagani Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Rosaria","family":"Villa","sequence":"additional","affiliation":[{"name":"Hematology Department General Hospital Santa Maria di Loreto  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Mettivier","sequence":"additional","affiliation":[{"name":"Hematology Department General HospitalSan Giovanni di Dio e Ruggi D\u2019Aragona  Salerno Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Graziani","sequence":"additional","affiliation":[{"name":"Hematology Department General Hospital, San Giuseppe Moscati  Aversa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Sammartano","sequence":"additional","affiliation":[{"name":"Hematology Department University Federico II  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alberto","family":"Fresa","sequence":"additional","affiliation":[{"name":"Hematology\u2010Oncology and Stem\u2010Cell Transplantation Unit, Department of Onco\u2010Hematology and Innovative Diagnostics Istituto Nazionale Tumori IRCCS \u2010 Fondazione G. Pascale  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonello","family":"Sica","sequence":"additional","affiliation":[{"name":"Hematology Department University Vanvitelli  Napoli Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Rodolfo","family":"Nunziata","sequence":"additional","affiliation":[{"name":"Hematology Department General Hospital, San Giuseppe Moscati  Aversa Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Farina","sequence":"additional","affiliation":[{"name":"Hematology Department Hospital of National Relevance San Anna e San Sebastiano  Caserta Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,13]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1182\/hematology.2024000656"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2025.2469719"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2021014488"},{"issue":"3","key":"e_1_2_10_5_1","article-title":"Final Analysis of Fixed\u2010Duration Ibrutinib + Venetoclax for Chronic Lymphocytic Leukemia (CLL)\/Small Lymphocytic Lymphoma (SLL) in The Phase 2 CAPTIVATE Study","volume":"43","author":"Ghia P.","year":"2025","journal-title":"Oral Presentation S156. EHA Congress"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2409804"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.medj.2025.100665"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00452-7"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annonc.2024.06.016"},{"key":"e_1_2_10_10_1","unstructured":"National Comprehensive Cancer Network \u201cChronic Lymphocytic Leukemia\/Small Lymphocytic Lymphoma. NCCN Guidelines Version 2.2026 \u201d2026 https:\/\/www.nccn.org\/guidelines\/guidelines\u2010detail?category=1&id=1478."},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000097"},{"issue":"10","key":"e_1_2_10_12_1","first-page":"1","article-title":"The Delphi Technique: Making Sense of Consensus","volume":"12","author":"Hsu C. C.","year":"2007","journal-title":"Practical Assessment, Research & Evaluation"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.21.01210"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2211582"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2515458"},{"key":"e_1_2_10_17_1","unstructured":"l.Chunhua y.Wang R. P.Gale et\u00a0al. \u201cUnreliable Predictive Value of Measurable Residual Disease for Progression\u2010Free Survival in Contemporary Chronic Lymphocytic Leukemia Regimens \u201dabs25\u20102132. ASH 2025."},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.24.01192"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2023022269"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/sim.4780080407"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41375\u2010026\u201002945\u2010y"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2025.2591606"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-025-06706-2"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2025029876"}],"container-title":["European Journal of Haematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70195","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/ejh.70195","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/ejh.70195","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T16:32:00Z","timestamp":1783009920000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/ejh.70195"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,13]]},"references-count":23,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1111\/ejh.70195"],"URL":"https:\/\/doi.org\/10.1111\/ejh.70195","archive":["Portico"],"relation":{},"ISSN":["0902-4441","1600-0609"],"issn-type":[{"value":"0902-4441","type":"print"},{"value":"1600-0609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,13]]},"assertion":[{"value":"2026-02-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-13","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}