title: Expanding the armamentarium for chronic lymphocytic leukemia: A review of novel agents in the management of chronic lymphocytic leukemia.
abstract: Treatment options for chronic lymphocytic leukemia, the most common leukemia in the United States, have expanded rapidly in recent years. While traditional chemoimmunotherapy still remains a mainstay for young, fit patients, a number of novel targeted therapies have emerged that have changed the therapeutic landscape. Two innovative anti-CD20 monoclonal antibodies, obinutuzumab and ofatumomamab, have demonstrated activity in chronic lymphocytic leukemia and represent well-tolerated options in upfront management of elderly patients or in those with significant comorbidities. Agents targeting the B-cell receptor pathway, ibrutinib and idelalisib, have excellent activity in chronic lymphocytic leukemia, particularly in those patients with 17p deletions, in which responses to chemoimmunotherapy are traditionally dismal. Venetoclax (ABT-199), the recently FDA-approved BCL2 inhibitor, as well as several other agents and therapy combinations in the pipeline offer great promise for patients with chronic lymphocytic leukemia, particularly in the relapsed/refractory setting. This article comprehensively reviews the data for novel agents in chronic lymphocytic leukemia, including the pharmacology of therapies, unique toxicities, and other practical management considerations for clinicians.
authors.affiliation: Department of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, USA.
authors.forename: Bernard L
authors.initials: BL
authors.lastname: Marini
authors.affiliation: Department of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Samanas
authors.affiliation: Department of Pharmacy Services and Clinical Sciences, University of Michigan Health System and College of Pharmacy, USA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Perissinotti
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000188:drug therapy*; D010880:Piperidines; D011687:Purines / Q000008:administration & dosage; D011720:Pyrazoles / Q000008:administration & dosage; D011743:Pyrimidines / Q000008:administration & dosage; D052999:Quinazolinones / Q000008:administration & dosage
chemical_list: D010880:Piperidines; D011687:Purines; D011720:Pyrazoles; D011743:Pyrimidines; D052999:Quinazolinones; C551803:ibrutinib; D000225:Adenine; C552946:idelalisib
keywords: Chronic lymphocytic leukemia; ibrutinib; idelalisib; monoclonal antibodies; venetoclax