Front-line treatment of CLL in the era of novel agents

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• 作者：Tadeusz Robak^a ; ^{robaktad@csk.umed.lodz.pl} ; Stephan Stilgenbauer^b ; ^{Stephan.Stilgenbauer@uniklinik-ulm.de} ; Alessandra Tedeschi^c ; ^{alessandra.tedeschi@ospedaleniguarda.it}
• 关键词：Chronic lymphocytic leukaemia ; First-line ; Bruton&rsquo ; s kinase inhibitor ; Ibrutinib ; Elderly ; PI3Kδ inhibitor ; Idelalisib ; Venetoclax
• 刊名：Cancer Treatment Reviews
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：53
• 期：Complete
• 页码：70-78
• 全文大小：361 K
• 卷排序：53

文摘

Although chemoimmunotherapy prolongs survival and as such, is the standard of care for treatment-naïve patients, its effectiveness may be reduced by associated toxicity and dose reductions. In addition, it has been associated with the development of myelosuppression and secondary neoplasms; treatments are hence needed which offer greater survival and lowered toxicity. A range of new targeted agents, ibrutinib, idelalisib and venetoclax, have demonstrated such a balance in a second-line setting, offering CLL patients durable remissions and a modest toxicity profile. Ibrutinib has since been given first-line approval, and with news of second-generation targeted agents on the horizon, high-level discussions have taken place concerning their use in elderly or unfit patients; with potential use in younger patients in a first-line setting. This article reviews the potential first-line therapeutic options for treating CLL and their clinical potential and examines whether first-line chemotherapy has a place in the age of targeted agents.