Onkologie. 2024:18(5):318-321 | DOI: 10.36290/xon.2024.066

Innovations and developments in chronic lymphocytic leukemia therapy

Martin Šimkovič
IV. interní hematologická klinika, Fakultní nemocnice Hradec Králové

New findings in the biology of chronic lymphocytic leukemia (CLL) have major implications for the treatment of this disease. CLL cells exhibit a dependence on increased expression of BCL-2, an autonomous BCR signaling pathway, and are charac­terized by overexpression of the p110 PI3K delta kinase isoform and BTK kinase, which promotes tumor cell survival. Targeted therapies such as the monoclonal antibodies rituximab and obinutuzumab, along with small molecules such as ibrutinib, idelalisib, and venetoclax, have dramatically expanded therapeutic options, resulting in improved overall patient survival. In this context, it is note­worthy that patients starting treatment with ibrutinib have survival rates comparable to the general population. However, not all issues have been resolved, as there are questions regarding the immune system, consistency in treatment approaches and long-term strategies for young patients, especially those with Richter transformation. Although BTK and BCL-2 inhibitors can positively influence the immune system, we still face challenges related to infections and secondary tumors. Regarding Richter transformation, identification of specific genetic abnormalities may allow more targeted and effective therapies in the future, including CAR-T therapy and bispecific antibodies.

Keywords: CLL, BTK inhibitors, BCl-2 inhibitors, venetoclax, Richter's transformation.

Accepted: November 18, 2024; Published: November 28, 2024  Show citation

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Šimkovič M. Innovations and developments in chronic lymphocytic leukemia therapy. Onkologie. 2024;18(5):318-321. doi: 10.36290/xon.2024.066.
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