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Review
. 2021 May 19;13(10):2468.
doi: 10.3390/cancers13102468.

Current Treatment Options in CLL

Moritz Bewarder  1 , Stephan Stilgenbauer  1 , Lorenz Thurner  1 , Dominic Kaddu-Mulindwa  1
Affiliations
Review

Current Treatment Options in CLL

Moritz Bewarder et al. Cancers (Basel). .

Abstract

After impressive developments in recent years with the rise of new targeted agents, chemoimmunotherapy (CIT) only plays a minor role in the treatment of patients with chronic lymphocytic leukemia (CLL). Inhibitors of the Bruton tyrosine kinase (BTK), such as ibrutinib or more recently acalabrutinib, are highly effective, even in poor-risk or chemo-refractory patients. Venetoclax, an inhibitor of the anti-apoptotic BCL2 protein and, to a lesser extent, phosphoinositide-3 kinase (PI3K) delta inhibitors, add to the armamentarium of targeted agents for the treatment of CLL. Furthermore, anti-CD20 monoclonal antibodies are used very successfully either alone or in combination with BTK, BCL2 or PI3K inhibitors. Despite these advances, there is still an ongoing pursuit for new therapeutic approaches in the treatment of CLL. An even bigger challenge poses the determination of the optimal combination and sequence of those drugs. Here, we give an overview of current treatment options in CLL, weighing the advantages and disadvantages of each approach in the light of different clinical settings.

Keywords: BCL2 inhibitors; BTK inhibitor; chronic lymphocytic leukemia; treatment.

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Conflict of interest statement

M.B. received travel support from Abbvie. D.K.-M. received honoraria for advisory board members and speaker honoraria from Janssen, Sanofi, Abbvie, Gilead, Takeda, Novartis and travel support from Janssen, Gilead, Novartis, Takeda. L.T. received travel support from EUSA-Pharma, Janssen and Abbvie and received honoraria for advisory boards from Takeda, Astra-Zeneca, Merck and EUSA-Pharma. S.S. received research funding and is an advisory board member for AbbVie, Amgen, Boehringer Ingelheim, Celgene, Genentech, Genzyme, Gilead, GSK, Janssen, Mundipharma, Novartis, Pharmacyclics, Hoffmann La-Roche, and Sanofi.

Figures

Figure 1
Figure 1
Frontline treatment algorithm in CLL.
Figure 2
Figure 2
Treatment algorithm in relapsed/refractory CLL.
See this image and copyright information in PMC

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