Revisão Acesso aberto Revisado por pares

Targeted Therapy in Chronic Lymphocytic Leukemia: Past, Present, and Future

2013; Elsevier BV; Volume: 35; Issue: 9 Linguagem: Inglês

10.1016/j.clinthera.2013.08.004

ISSN

1879-114X

Autores

Alexey V. Danilov,

Tópico(s)

Lymphoma Diagnosis and Treatment

Resumo

Chronic lymphocytic leukemia (CLL) is the most prevalent leukemia in the western world. Recent advances in understanding the biology of B-cell malignancies have resulted in the development of novel agents targeting key prosurvival pathways in the neoplastic B cell.The goal of this article was to summarize current literature on the emerging therapeutic approaches in CLL and B-cell malignancies.A literature review was performed, identifying pathways and key clinical trials involving novel therapies in CLL, with special emphasis on B-cell receptor (BCR)-targeting agents.Understanding the biology of the BCR-signaling pathway has led to identification of novel molecular targets. Most notably, inhibitors of Bruton tyrosine kinase and phosphatidylinositide 3-kinase-δ have entered clinical trials and demonstrated high response rates in CLL, including high-risk disease. Cyclin-dependent kinase inhibitors may evolve into an alternative therapeutic approach in CLL. New drugs that target molecules within and outside of the BCR-signaling pathway have shown promise in preclinical studies.Both preclinical and early clinical trial results involving novel targeted therapies suggest that the standard treatment paradigm in CLL and B-cell malignancies will soon change. Particular attention should be paid to the BCR-targeting agents, whose favorable adverse effect profile may improve the lives of elderly patients with CLL.

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