Cecilia C S Yeung1,2,3, Mazyar Shadman4,5,6. 1. Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, G71910, Seattle, WA, 98109, USA. cyeung@fredhutch.org. 2. Department of Pathology, University of Washington, Seattle, WA, USA. cyeung@fredhutch.org. 3. Seattle Cancer Care Alliance, Seattle, WA, USA. cyeung@fredhutch.org. 4. Clinical Research Division, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, G71910, Seattle, WA, 98109, USA. 5. Seattle Cancer Care Alliance, Seattle, WA, USA. 6. Department of Medicine, University of Washington, Seattle, WA, USA.
Abstract
PURPOSE OF REVIEW: Treatment of chronic lymphocytic leukemia (CLL) has undergone a major shift since introduction of multiple targeted agents. B cell receptor inhibitors that target either bruton tyrosine kinase (ibrutinib) or phosphatidylinositol 3-kinases (idelalisib and duvelisib) and BCL-2 inhibitor venetoclax have become the mainstay of treatment. RECENT FINDINGS: Newer generations of monoclonal antibodies targeting CD20 (obinutuzumab and ofatumumab) are commonly used with novel drugs or chemotherapy agents and result in improved efficacy. At the same time, chemoimmunotherapy remains a reasonable option for selected patients. Therefore, with variety of reasonable options, choice of treatment in first-line or relapsed setting has become more challenging. Better understanding of the molecular and cytogenetics data for each patient is critical to improve management of patients with CLL. Herein, we review our approach to diagnosis and treatment of CLL in the era of novel therapeutic agents.
PURPOSE OF REVIEW: Treatment of chronic lymphocytic leukemia (CLL) has undergone a major shift since introduction of multiple targeted agents. B cell receptor inhibitors that target either bruton tyrosine kinase (ibrutinib) or phosphatidylinositol 3-kinases (idelalisib and duvelisib) and BCL-2 inhibitor venetoclax have become the mainstay of treatment. RECENT FINDINGS: Newer generations of monoclonal antibodies targeting CD20 (obinutuzumab and ofatumumab) are commonly used with novel drugs or chemotherapy agents and result in improved efficacy. At the same time, chemoimmunotherapy remains a reasonable option for selected patients. Therefore, with variety of reasonable options, choice of treatment in first-line or relapsed setting has become more challenging. Better understanding of the molecular and cytogenetics data for each patient is critical to improve management of patients with CLL. Herein, we review our approach to diagnosis and treatment of CLL in the era of novel therapeutic agents.
Entities:
Keywords:
B cell lymphoma, PLL, CLL; FCR, BTK, BCL2, PI3Kδ; FISH; Karyotype; Microarray; Prognosis; Targeted mutation testing by NGS
Authors: I Del Giudice; Z Davis; E Matutes; N Osuji; N Parry-Jones; A Morilla; V Brito-Babapulle; D Oscier; D Catovsky Journal: Leukemia Date: 2006-04-27 Impact factor: 11.528
Authors: I Del Giudice; N Osuji; T Dexter; V Brito-Babapulle; N Parry-Jones; S Chiaretti; M Messina; G Morgan; D Catovsky; E Matutes Journal: Leukemia Date: 2009-07-30 Impact factor: 11.528
Authors: Valentin Goede; Kirsten Fischer; Raymonde Busch; Anja Engelke; Barbara Eichhorst; Clemens M Wendtner; Tatiana Chagorova; Javier de la Serna; Marie-Sarah Dilhuydy; Thomas Illmer; Stephen Opat; Carolyn J Owen; Olga Samoylova; Karl-Anton Kreuzer; Stephan Stilgenbauer; Hartmut Döhner; Anton W Langerak; Matthias Ritgen; Michael Kneba; Elina Asikanius; Kathryn Humphrey; Michael Wenger; Michael Hallek Journal: N Engl J Med Date: 2014-01-08 Impact factor: 91.245
Authors: H Döhner; S Stilgenbauer; A Benner; E Leupolt; A Kröber; L Bullinger; K Döhner; M Bentz; P Lichter Journal: N Engl J Med Date: 2000-12-28 Impact factor: 91.245
Authors: Brian J Lannutti; Sarah A Meadows; Sarah E M Herman; Adam Kashishian; Bart Steiner; Amy J Johnson; John C Byrd; Jeffrey W Tyner; Marc M Loriaux; Mike Deininger; Brian J Druker; Kamal D Puri; Roger G Ulrich; Neill A Giese Journal: Blood Date: 2010-10-19 Impact factor: 22.113
Authors: Sarah S Fung; Kortney L Hillier; Chantal S Leger; Irwin Sandhu; Linda M Vickars; Paul F Galbraith; Charles H Li; Heather A Leitch Journal: Leuk Lymphoma Date: 2007-06
Authors: Ranjana H Advani; Joseph J Buggy; Jeff P Sharman; Sonali M Smith; Thomas E Boyd; Barbara Grant; Kathryn S Kolibaba; Richard R Furman; Sara Rodriguez; Betty Y Chang; Juthamas Sukbuntherng; Raquel Izumi; Ahmed Hamdy; Eric Hedrick; Nathan H Fowler Journal: J Clin Oncol Date: 2012-10-08 Impact factor: 44.544
Authors: Tait D Shanafelt; Neil E Kay; Tim G Call; Clive S Zent; Diane F Jelinek; Betsy LaPlant; William G Morice; Curtis A Hanson Journal: Leuk Res Date: 2008-01-07 Impact factor: 3.156