Department I of Internal Medicine & Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University Hospital Cologne, Cologne, Germany.
Department of Hematology, Oncology, Immunology, Palliative Care, Infectious Diseases & Tropical Medicine, Klinikum Schwabing, Munich, Germany.
Future Oncol. 2018 Mar;14(6):499-513. doi: 10.2217/fon-2017-0442. Epub 2018 Feb 21.
Four Phase II trials (clinical trials numbers: NCT02345863, NCT02401503, NCT02445131 and NCT02689141) evaluate a different combination of targeted agents in an all-comer population of approximately 60 patients with chronic lymphocytic leukemia irrespective of prior treatment, physical fitness and genetic risk factors. Patients with a higher tumor load start with a debulking treatment with bendamustine. The subsequent induction and maintenance treatment with an anti-CD20 antibody (obinutuzumab or ofatumumab) and a targeted oral agent (ibrutinib, idelalisib or venetoclax) are continued until achievement of a complete response and minimal residual disease negativity.
This strategy represents a new era of chronic lymphocytic leukemia therapy where chemotherapy is increasingly replaced by targeted agents and treatment duration is tailored to the patient's individual tumor load and response.
四项 II 期临床试验（临床试验编号：NCT02345863、NCT02401503、NCT02445131 和 NCT02689141）评估了在未经治疗、体能状况和遗传风险因素各不相同的约 60 例慢性淋巴细胞白血病患者中，靶向药物联合应用的不同方案。肿瘤负荷较高的患者先接受苯达莫司汀减瘤治疗。随后，使用抗 CD20 抗体（奥滨尤妥珠单抗或奥法妥珠单抗）和靶向口服药物（伊布替尼、idelalisib 或 venetoclax）进行诱导和维持治疗，直至达到完全缓解和微小残留病灶阴性。
该策略代表了慢性淋巴细胞白血病治疗的新时代，其中化疗正逐渐被靶向药物替代，治疗时间根据患者的个体肿瘤负荷和反应进行调整。
