CaDAnCe-304

CaDAnCe-304, sponsored by BeOne, formerly BeiGene, is the first phase 3 of a protein degrader in leukaemia, pitting BTK destruction against the best available BTK inhibitor in relapsed or refractory chronic lymphocytic leukaemia after a covalent BTK inhibitor. It is an open-label trial of about 500 patients randomised equally to the BTK degrader BGB-16673 or pirtobrutinib, each at 200 mg daily, with progression-free survival by independent review as the primary endpoint, following the CaDAnCe-101 phase 1 in which most of 66 patients responded, and enrolment runs from 2025 to 2027. OnCo links it to chronic lymphocytic leukaemia, protein degradation, BTK as a target, BGB-16673, pirtobrutinib and the bottleneck of acquired resistance. Whether degrading BTK beats inhibiting it in patients whose disease has already escaped one inhibitor is the question it exists to answer.