Frontline Therapy of CLL-Changing Treatment Paradigms.

IF 2.7 3区医学 Q2 HEMATOLOGY Current Hematologic Malignancy Reports Pub Date : 2024-04-01 Epub Date: 2024-02-10 DOI:10.1007/s11899-024-00726-x

Catherine C Coombs

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Abstract

Purpose of review: The therapeutic landscape for chronic lymphocytic leukemia (CLL) has undergone a complete makeover following the introduction of highly effective targeted therapies, beginning with ibrutinib which first attained regulatory approval for CLL in 2014.

Recent findings: In recent years, we have seen further refinement of therapeutic options with the development of newer-generation Bruton's tyrosine kinase inhibitors (BTKi) including acalabrutinib and zanubrutinib that improve upon the safety of ibrutinib. Additionally, venetoclax-based approaches, combined with anti-CD20 antibodies, have allowed for time-limited targeted therapeutic strategies which are particularly attractive for certain subsets of patients though have demonstrated efficacy across all subgroups. Lastly, there is an ongoing movement toward the development of time-limited strategies inclusive of both a BTKi and venetoclax that may further widen potential options. CLL patients requiring frontline therapy have a unique burden of choice between highly effective therapies that differ substantially with respect to side effect profiles and schedules. This review will focus on the frontline management of CLL in the setting of these rapidly changing options.

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慢性淋巴细胞白血病的前线治疗--改变治疗范式。

综述目的：随着高效靶向疗法的推出，慢性淋巴细胞白血病（CLL）的治疗格局发生了彻底改变，首先是伊布替尼（ibrutinib）于2014年首次获得监管机构批准用于CLL：近年来，随着新一代布鲁顿酪氨酸激酶抑制剂（BTKi）的开发，我们看到了治疗方案的进一步完善，包括阿卡布芦替尼（acalabrutinib）和扎努布芦替尼（zanubrutinib），它们提高了伊布替尼的安全性。此外，基于 Venetoclax 的方法与抗 CD20 抗体相结合，实现了有时间限制的靶向治疗策略，这对某些亚组患者特别有吸引力，尽管在所有亚组中都显示出了疗效。最后，目前正在开发同时包含 BTKi 和 venetoclax 的限时策略，这可能会进一步扩大潜在的选择范围。需要接受一线治疗的 CLL 患者在选择高效疗法时面临着独特的负担，而这些疗法在副作用和治疗时间上存在很大差异。本综述将重点讨论在这些快速变化的选择中如何对 CLL 进行一线治疗。

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来源期刊

Current Hematologic Malignancy Reports ONCOLOGY-HEMATOLOGY

CiteScore

6.00

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： his journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hematologic malignancy. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as leukemia, lymphoma, myeloma, and T-cell and other lymphoproliferative malignancies. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.

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