Breaking News - Duke Center for Chronic Lymphocytic Leukemia
The way we treat Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma has changed dramatically over the past several years. While chemotherapy is still the mainstay of therapy of CLL/SLL, other options exist. These include FDA approved immunotherapy (rituximab, ofatumomab, and alemtuzumab) and new investigational targeted and immune therapies. Some of the new therapies currently undergoing testing are described here.
- A Bruton tyrosine kinase (BTK) inhibitor.
- BTK is a protein in the B-cell receptor signaling pathway.
- Interim results of treatment of 116 CLL/SLL patients with single agent ibrutinib demonstrated responses in 81% of elderly patients receiving initial therapy, 87% of patients with relapsed or refractory disease, and 79% of patients with "high risk" relapsed or refractory disease.
A PI3K-delta inhibitor.
- PI3K-delta is a specific form of PI3K that is part of the B-cell receptor signaling pathway.
- Initial results of a clinical trial of this single agent in CLL/SLL showed approximately 8 out of 10 CLL/SLL patients had some response, including patients with high risk features. Further work has shown extremely high activity of GS1101 when it is combined with rituximab, bendamustine, or both.
- New approaches to attack CLL/SLL cells using the immune system are being developed.
- One of these is the use of chimeric antigen receptor (CAR) modified T-cells.
- The results of one study using these CAR T-cells to treat a small number of heavily pretreated and high risk CLL/SLL patients resulted in a dramatic response and elimination of detectable CLL/SLL cells.
We have hope that these and other new therapies will dramatically change the way we treat CLL/SLL.
Many thanks to Sandip Patel, Hematology/Oncology fellow at Duke University, for assistance in compiling the information on this web page.
Duke University Cancer Center