University of Pennsylvania, 3400 Civic Center Blvd, PCAM 12 South, Philadelphia, PA, 19104, USA.
Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.
Curr Oncol Rep. 2018 Apr 11;20(6):49. doi: 10.1007/s11912-018-0694-x.
B cell signaling agents, including ibrutinib, idelalisib, and the BCL-2 inhibitor venetoclax have become an integral part of therapy for patients with non-Hodgkin's lymphomas. The toxicity profiles of these medications is distinct from chemoimmunotherapy. Here, we will review the mechanism of action of these drugs, their efficacy, and toxicity management.
Ibrutinib use is associated with increased risk of atrial fibrillation and bleeding which can be managed using dose interruptions and modifications. Patients on idelalisib require close clinical and frequent laboratory monitoring, particularly of liver function tests to ensure there are no serious adverse events. Monitoring for infections is important in patients on both idelalisib and ibrutinib. Venetoclax requires close clinical and laboratory monitoring to prevent significant tumor lysis. Targeted B cell receptor therapies each have unique side effect profiles which require careful clinical monitoring. As we continue to use these therapies, optimal management strategies will continue to be elucidated.
B 细胞信号转导剂，包括伊布替尼、idelalisib 和 BCL-2 抑制剂 venetoclax，已成为治疗非霍奇金淋巴瘤患者的重要组成部分。这些药物的毒性谱与化疗免疫治疗不同。在这里，我们将回顾这些药物的作用机制、疗效和毒性管理。
伊布替尼的使用与心房颤动和出血风险增加相关，可以通过中断和调整剂量来管理。idelalisib 治疗的患者需要密切的临床和频繁的实验室监测，特别是肝功能检查，以确保没有严重的不良事件。在使用伊布替尼和 ibrutinib 的患者中，监测感染很重要。venetoclax 需要密切的临床和实验室监测，以防止严重的肿瘤溶解。每种靶向 B 细胞受体的治疗方法都有独特的副作用谱，需要仔细的临床监测。随着我们继续使用这些疗法，将继续阐明最佳管理策略。
