ALSG consensus for relapsed/refractory disease Ibrutinib should be considered in the second-line rather than later-line setting. Ibrutinib is tolerable in Asian patients. Adverse events observed in clinical practice (e.g., non-specific musculoskeletal symptoms, skin dryness or itching, changes to nails and hair) are not well characterized in the literature and more Asian real-world data might be needed. Follow-on BTK inhibitors including zanubrutinib could be considered if available, and a difference to ibrutinib in terms of efficacy and safety remains to be shown. Clinical trial enrollment is strongly suggested where possible, especially for patients with TP53 mutation associated with poor prognosis.