Phase 1 Data Collection: Pre-Intervention Survey

We are hoping to gain insight into current clinical practices and challenges in sequencing treatment for patients with R/R CLL/SLL. We are seeking to get a better understanding of the key factors involved in treatment decisions when prescribing covalent and non-covalent BTK inhibitors and other agents/regimens for this patient population, including venetoclax-containing regimens.

Your Name

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Last

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2. How many patients with R/R CLL/SLL do you manage annually?

a. 1-5
b. 6-10
c. 11-20
d. >20

3. Which of the following do you routinely utilize to assess risk in a patient with R/R CLL/SLL needing next treatment? (Select all that apply)

4. How often do you perform molecular or cytogenetic testing (e.g., FISH, NGS) prior to selecting therapy for R/R CLL/SLL?

Always	Often	Sometimes	Rarely	Never	Depends on the treatment I am considering
AlwaysAlways	OftenOften	SometimesSometimes	RarelyRarely	NeverNever	Depends on the treatment I am consideringDepends on the treatment I am considering

If you answered Never, please simply explain (e.g., I don’t have access to genetic testing):

5. Which therapies have you prescribed for R/R CLL/SLL in the past 6 months? (Select all that apply)

6. How confident are you in selecting appropriate BTK inhibitors for R/R CLL/SLL?

Very confident	Somewhat confident	Neutral	Somewhat unconfident	Not at all confident
Very confidentItem #1 Very confident	Somewhat confidentItem #1 Somewhat confident	NeutralItem #1 Neutral	Somewhat unconfidentItem #1 Somewhat unconfident	Not at all confidentItem #1 Not at all confident

7. In patients previously treated with a covalent BTK inhibitor, how often do you test for BTK resistance mutations before selecting a subsequent therapy?

Always	Often	Sometimes	Rarely	Never	Depends on what next treatment I am considering
AlwaysItem #1 Always	OftenItem #1 Often	SometimesItem #1 Sometimes	RarelyItem #1 Rarely	NeverItem #1 Never	Depends on what next treatment I am consideringItem #1 Depends on what next treatment I am considering

If you answered Never, please simply explain (e.g., I don’t have access to testing for resistance, results would not inform my choice of therapy)

access R/R 3. Which

8. Have you ever prescribed a non-covalent BTK inhibitor (e.g., pirtobrutinib)?

Yes, currently prescribe
Yes, have prescribed in past
No, but considering it
No, I am not familiar with it

9. What is your primary rationale for prescribing a non-covalent BTK inhibitor (if applicable)?

a. Prior BTK inhibitor intolerance
b. Prior BTK inhibitor resistance (e.g., C481S)
c. Efficacy in R/R setting, based on recent evidence
d. Favorable safety profile
e. Participation in clinical trial
f. Other

10. What concerns, if any, do you have about prescribing a non-covalent BTK inhibitor? (Select all that apply)

a. Limited long-term data/follow-up
b. Access or reimbursement issues
c. Safety/tolerability concerns or unfamiliar with AE management
d. Lack of familiarity with this class of agent
e. Potential for cross-resistance to covalent BTK inhibitors
f. It is not included in institutional formulary
g. Other
h. No concerns

11. How important are the following factors in guiding your treatment selection for your patients with R/R CLL/SLL? [For each row, check the level of importance for each of the following factors]

	Not Important	Somewhat Important	Important	Very Important
Del(17p)	Not ImportantDel(17p) Not Important	Somewhat ImportantDel(17p) Somewhat Important	ImportantDel(17p) Important	Very ImportantDel(17p) Very Important
TP53 mutation status	Not ImportantTP53 mutation status Not Important	Somewhat ImportantTP53 mutation status Somewhat Important	ImportantTP53 mutation status Important	Very ImportantTP53 mutation status Very Important
IGHV mutation status	Not ImportantIGHV mutation status Not Important	Somewhat ImportantIGHV mutation status Somewhat Important	ImportantIGHV mutation status Important	Very ImportantIGHV mutation status Very Important
Age/frailty	Not ImportantAge/frailty Not Important	Somewhat ImportantAge/frailty Somewhat Important	ImportantAge/frailty Important	Very ImportantAge/frailty Very Important
Concomitant medications and/or change to comorbidities	Not ImportantConcomitant medications and/or change to comorbidities Not Important	Somewhat ImportantConcomitant medications and/or change to comorbidities Somewhat Important	ImportantConcomitant medications and/or change to comorbidities Important	Very ImportantConcomitant medications and/or change to comorbidities Very Important
Prior intolerance to BTK inhibitors	Not ImportantPrior intolerance to BTK inhibitors Not Important	Somewhat ImportantPrior intolerance to BTK inhibitors Somewhat Important	ImportantPrior intolerance to BTK inhibitors Important	Very ImportantPrior intolerance to BTK inhibitors Very Important
Patient preference/goals	Not ImportantPatient preference/goals Not Important	Somewhat ImportantPatient preference/goals Somewhat Important	ImportantPatient preference/goals Important	Very ImportantPatient preference/goals Very Important
Patient adherence-related factors	Not ImportantPatient adherence-related factors Not Important	Somewhat ImportantPatient adherence-related factors Somewhat Important	ImportantPatient adherence-related factors Important	Very ImportantPatient adherence-related factors Very Important

14. What have been the most significant challenges you have faced in managing patients with R/R CLL/SLL on BTK inhibitors (e.g., tolerability, resistance, adherence, access)?

15. What educational or clinical resources would be most helpful to you in optimizing the use of BTK inhibitors, including newer agents like pirtobrutinib, in your practice?