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Indication – Leukemia2024-06-03T16:14:37+01:00

Leukemia

Current insights into BTK inhibition and other targeted approaches in CLL

June 17th, 2023|

In the setting of early-stage, asymptomatic chronic lymphocytic leukemia (CLL), the concept of watch & wait in the era of targeted agents was challenged by the placebo-controlled, double-blind, phase III CLL12 study. This trial assessed the use of ibrutinib 420 mg OD (n = 182) vs. placebo (n = 181) until symptomatic disease progression in treatment-naïve patients with asymptomatic CLL Binet stage A who had an increased risk due to factors such as del(17p), IGHV mutation status, or age.

Clinical findings with sundry targets in various B-cell malignancies

December 13th, 2022|

Recurrent follicular lymphoma (FL) and marginal zone lymphoma (MZL) are treated similarly, mostly with single-agent rituximab. In patients with relapsed/refractory FL, the combination of lenalidomide with rituximab (R2) has previously demonstrated promising efficacy. The multicenter, double-blind, randomized, phase III AUGMENT study was initiated to compare time-limited treatment for approximately one year with R2 vs. rituximab plus placebo in patients with FL grade I-IIIa or MZL who had already received ≥ 1 prior systemic chemotherapy, immunotherapy or chemoimmunotherapy but who were not refractory to rituximab.

Chronic lymphocytic leukemia: moving towards new horizons

December 13th, 2022|

The first-in-class, covalent BTK inhibitor ibrutinib has transformed the treatment of patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). However, toxicities frequently lead to treatment discontinuation. Moreover, exposure coverage between dosing intervals falls below the IC50 threshold, and BTK occupancy at trough levels is variable.

Further steps to improve efficacy and safety in acute myeloid leukemia

December 13th, 2022|

Venetoclax 400 mg QD in combination with azacitidine 75 mg/m2 on days 1–7 has been approved for the treatment of patients with newly diagnosed acute myeloid leukemia (AML) who are ineligible for intensive chemotherapy based on the phase III VIALE-A trial that met its primary endpoint of overall survival (OS) at the time of the interim analysis conducted in March 2020.

Tackling acute myeloid leukemia via diverse pathways

June 12th, 2022|

Mutations of FLT3 are found in approximately 30 % of patients with newly diagnosed acute myeloid leukemia (AML), with the internal tandem duplication (ITD) representing the most common type. FLT3-ITDhigh is associated with high leukemia burden and poor prognosis. Quizartinib has been developed as a potent and selective, second-generation type II FLT3 inhibitor.

Updates and ancillary analyses in the setting of chronic lymphocytic leukemia

June 12th, 2022|

In fit patients with advanced CLL of favorable genetic risk, chemoimmunotherapy (CIT) consisting of fludarabine/cyclophosphamide/rituximab (FCR) or bendamustine/rituximab (BR) still represents the treatment standard. Another potential strategy, however, is time-limited therapy consisting of obinutuzumab plus venetoclax (GV) with or without a BTK inhibitor.

Bruton’s tyrosine kinase inhibition in CLL: present and future

April 12th, 2022|

BTK inhibitors have been important game changers in the management of B-cell lymphoma in general and B-CLL and small lymphocytic lymphoma in particular. Federico Pea, MD, University of Bologna, Italy, discussed differences between the irreversible BTK inhibitors ibrutinib, acalabrutinib and zanubrutinib. The second-generation drugs acalabrutinib and zanubrutinib demonstrated higher kinase selectivity than the first-in-class agent ibrutinib, which implies an improved efficacy-toxicity ratio.

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