Novel therapies for chronic lymphocytic leukemia.
New therapies for chronic lymphocytic leukemia (CLL) are moving away from non-specific cytotoxic to more targeted approaches. The monoclonal antibody alemtuzumab induces responses in 33% to 43% of patients with relapsed or refractory disease, with 2-5% CR. Side effects include infusional reactions as well as immunosuppressive effects. Rituximab has limited activity in relapsed refractory patients, but response rates are comparable to follicular non-Hodgkin's lymphoma in untreated patients. Other antibodies in early phases of development include anti-CD23 [IDEC-152], anti-CD22 [epratuzumab], Hu1D10 [apolizumab], and anti-CD80 [anti-B7, IDEC-114]. Other agents that are being studied include denileukin diftitox fusion protein (Ontak), and bcl-2 antisense [G3139, Genasense]. The mechanism of action of the new drugs and their role in CLL, as well as the emergence of new prognostic markers are discussed.
Mavromatis
Blanche H
BH
Lombardi Cancer Center, Georgetown University Medical Center, Washington, DC 20057, USA.
Cheson
Bruce D
BD
D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D003582:Cytogenetics; D004167:Diphtheria Toxin / Q000627:therapeutic use*; D006801:Humans; D016130:Immunophenotyping; D007376:Interleukin-2 / Q000627:therapeutic use*; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D011379:Prognosis; D011993:Recombinant Fusion Proteins / Q000627:therapeutic use*; D013873:Thionucleotides / Q000627:therapeutic use*
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D004167:Diphtheria Toxin; D007376:Interleukin-2; D011993:Recombinant Fusion Proteins; D013873:Thionucleotides; C078456:denileukin diftitox; C408162:oblimersen