title: Novel agents versus chemotherapy as frontline treatment of CLL.
abstract: Chronic lymphocytic leukemia (CLL) is a neoplastic disorder of mature B lymphocytes. While traditionally treated with combinations of chemoimmunotherapy, the therapeutic options for CLL have expanded in recent years with the emergence of novel oral agents, such as the Bruton tyrosine kinase inhibitor ibrutinib, that are well tolerated and highly efficacious. The role of novel agents in the first-line setting is now being investigated in head-to-head clinical trials. In this discussion paper, we consider the role of novel agents in the up-front setting, using three case studies of treatment-naive patients to highlight how choice of therapy may be individualized depending on the characteristics of the patient and the disease, as well as patient preferences.
authors.affiliation: a Haematology Department , St Vincent's Hospital , Fitzroy , Australia.
authors.forename: Anna
authors.initials: A
authors.lastname: Piggin
authors.affiliation: a Haematology Department , St Vincent's Hospital , Fitzroy , Australia.
authors.forename: Emma
authors.initials: E
authors.lastname: Bayly
authors.affiliation: a Haematology Department , St Vincent's Hospital , Fitzroy , Australia.|b Haematology Department , Peter MacCallum Cancer Center , East Melbourne , Australia.|c Department of Medicine , University of Melbourne , Parkville , Australia.
authors.forename: Constantine S
authors.initials: CS
authors.lastname: Tam
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002872:Chromosome Deletion; D002880:Chromosomes, Human, Pair 11; D002882:Chromosomes, Human, Pair 13; D002986:Clinical Trials as Topic; D015897:Comorbidity; D005260:Female; D006801:Humans; D007143:Immunoglobulin Heavy Chains / Q000235:genetics; D007167:Immunotherapy; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009154:Mutation; D010880:Piperidines; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011720:Pyrazoles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D011743:Pyrimidines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D007143:Immunoglobulin Heavy Chains; D010880:Piperidines; D047428:Protein Kinase Inhibitors; D011720:Pyrazoles; D011743:Pyrimidines; C551803:ibrutinib; D000225:Adenine
keywords: Ibrutinib; idelalisib; obinutuzmab; venetoclax