Molica Stefano
a Department of Hematology-Oncology , Azienda Ospedaliera Pugliese-Ciaccio , Catanzaro , Italy.
Expert Rev Hematol. 2017 May;10(5):425-432. doi: 10.1080/17474086.2017.1313108. Epub 2017 Apr 12.
The therapy for chronic lymphocytic leukemia (CLL) is undergoing a major transformation. However, the seminal progresses realized to date with the use of novel agents, leave many practical questions unanswered. Areas covered: This review focuses on the recent data of the literature of small-kinase inhibitor (KI) molecules and how results of KI clinical trials may translate into current clinical practice. Several questions such as the advantage of combining small-KI molecules with anti-CD20 monoclonal antibodies or with chemo-immunotherapy in comparison to targeted agents alone are discussed. Expert commentary: Nowadays the challenge is to apply the principles of chemotherapy to combine different targeted agents with nonoverlapping toxicities. This approach is not likely to immediately change the standard of care, however, it raises relevant questions concerning the optimal strategy for incorporating novel agents in the treatment of CLL. Given the increasing number of patients who have access to treatment with small-KI molecules, generally administered over an extended duration, more sustainable pricing for such therapies is needed.
慢性淋巴细胞白血病（CLL）的治疗正在经历重大变革。然而，迄今为止使用新型药物所取得的重大进展仍留下许多实际问题未得到解答。涵盖领域：本综述聚焦于小分子激酶抑制剂（KI）分子的近期文献数据，以及KI临床试验结果如何转化为当前临床实践。讨论了几个问题，例如与单独使用靶向药物相比，将小分子KI分子与抗CD20单克隆抗体或化学免疫疗法联合使用的优势。专家评论：如今的挑战是应用化疗原则，将不同的靶向药物与无重叠毒性的药物联合使用。这种方法不太可能立即改变治疗标准，然而，它引发了有关在CLL治疗中纳入新型药物的最佳策略的相关问题。鉴于越来越多的患者能够接受小分子KI分子治疗，且通常需要长期给药，因此需要更可持续的此类疗法定价。
