Targeted therapy for chronic lymphocytic leukemia: current status and future directions.

The majority of patients with chronic lymphocytic leukemia (CLL) respond to chemo-immunotherapy. However, long-term remission remains elusive and the majority of patients will die of complications related to CLL. In this review we discuss the recent developments in targeted therapy for CLL. Targeted therapy has evolved beyond the cell surface targeting of CD20 with rituximab. Our review focuses on the evolution of antibody therapy in CLL, strategies to target effector T cells to the tumor, inhibition of the B-cell receptor signaling pathway, and finally targeting the mediators of apoptosis. With our improved understanding of the biology of CLL, the evolution of targeted therapy has resulted in significant clinical responses in patients who are refractory to traditional treatment options and holds the potential for a future where we can manage this disease without chemotherapy.