The Evolution of Targeted Therapies in Chronic Lymphocytic Leukaemia

Curr Hematol Malig Rep. 2020 Aug;15(4):343-349. doi: 10.1007/s11899-020-00586-1.

Abstract

Purpose of review: The treatment landscape for chronic lymphocytic leukaemia (CLL) is rapidly evolving, with several targeted agents recently approved. These compounds have dramatically changed the natural history of the disease.

Recent findings: However, with the array of effective therapies commercially available, the challenge is to define tailored treatment strategies able to realize a balance between treatment efficacy and toxicity or tolerance. New algorithms of treatment are being developed, and it appears that minimal residual disease (MRD) directed therapy will become the norm in the future. Clinical trials are looking at various combinations of novel therapies given with a defined, fixed-period of treatment based on MRD analysis. This approach enables patients to have a period of treatment-free remission instead of continuous therapy. In this review, we summarize this evolution of targeted therapies in CLL.

Keywords: B cell receptor inhibitors; Chronic lymphocytic leukaemia; Combination strategies; Indefinite treatment; Time-fixed therapy; Venetoclax.

Publication types

  • Review

MeSH terms

  • Adenine / adverse effects
  • Adenine / analogs & derivatives*
  • Adenine / therapeutic use
  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors*
  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use*
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / genetics
  • Leukemia, Lymphocytic, Chronic, B-Cell / immunology
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality
  • Molecular Targeted Therapy / adverse effects
  • Molecular Targeted Therapy / mortality
  • Molecular Targeted Therapy / trends*
  • Neoplasm, Residual
  • Piperidines / adverse effects
  • Piperidines / therapeutic use*
  • Protein Kinase Inhibitors / adverse effects
  • Protein Kinase Inhibitors / therapeutic use*
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Piperidines
  • Protein Kinase Inhibitors
  • ibrutinib
  • Agammaglobulinaemia Tyrosine Kinase
  • BTK protein, human
  • Adenine