University Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Torino, Italy.
Department of Molecular Biotechnology and Health Sciences, University of Torino , Torino, Italy.
Expert Rev Hematol. 2020 Aug;13(8):885-894. doi: 10.1080/17474086.2020.1796620. Epub 2020 Jul 26.
In patients with recurrent chronic lymphocytic leukemia (CLL), treatment with targeted agents such as Bruton tyrosine kinase inhibitors and the Bcl-2 inhibitor venetoclax is rapidly replacing chemo-immunotherapy regimens. Venetoclax has demonstrated efficacy as monotherapy in patients with previously treated CLL and has been evaluated in combination with the anti-CD20 monoclonal antibody rituximab.
This review focuses on the activity and toxicity of the time-limited combination of venetoclax plus rituximab for the treatment of relapsed or refractory CLL, presenting clinical trial results and data from correlative studies, with the aim of highlighting the strengths of this treatment approach and discuss weaknesses and possible areas of improvement. Data from PubMed indexed papers as well as from abstracts presented at major international conferences are included.
Deep responses with venetoclax-based regimens have been shown to allow time-limited treatment and prolonged remission off-therapy in patients with CLL. The clinical benefit of venetoclax and rituximab over chemo-immunotherapy has been demonstrated in recurrent CLL. Potential advantages of time-limited treatment approaches include avoidance of long-term toxicities, high drug costs, and the selection of resistant subclones.
在复发性慢性淋巴细胞白血病（CLL）患者中，靶向药物的治疗，如布鲁顿酪氨酸激酶抑制剂和 Bcl-2 抑制剂 Venetoclax，正在迅速取代化疗免疫治疗方案。Venetoclax 作为单药治疗先前治疗过的 CLL 已显示出疗效，并已与抗 CD20 单克隆抗体利妥昔单抗联合评估。
本综述重点介绍 Venetoclax 加利妥昔单抗限时联合治疗复发或难治性 CLL 的疗效和毒性，呈现临床试验结果和相关研究数据，旨在突出这种治疗方法的优势，并讨论其弱点和可能的改进领域。包括来自 PubMed 索引论文的数据以及在主要国际会议上提交的摘要数据。
基于 Venetoclax 的方案显示出深度应答，可使 CLL 患者的治疗时间受限，并延长停药后的缓解期。Venetoclax 和利妥昔单抗在复发性 CLL 中的疗效优于化疗免疫治疗。限时治疗方法的潜在优势包括避免长期毒性、药物高成本以及耐药亚克隆的选择。
