Small Molecule Inhibitors in Chronic Lymphocytic Lymphoma and B Cell Non-Hodgkin Lymphoma

Curr Hematol Malig Rep. 2017 Jun;12(3):207-216. doi: 10.1007/s11899-017-0383-0.

Abstract

Purpose of review: The purpose of this review is to summarize the available literature for the use of small molecule inhibitors in chronic lymphocytic leukemia and B cell non-Hodgkin lymphoma.

Recent findings: Ibrutinib, idelalisib, and venetoclax are small molecule inhibitors that have revolutionized therapeutic options for patients with CLL, particularly for those with high-risk disease including 17p deletion. These drugs are increasingly finding application in a variety of subtypes of B cell NHL. Intolerance and resistance are concerns for select patients, highlighting the need for continual development of alternate therapies. The treatment armamentarium for CLL and NHL is vastly different than it was just a few years ago. Patients have a much wider range of non-chemotherapy treatment options, some of which produce durable responses and have long-term tolerability. Future research directions will likely focus on identifying the optimal sequences and combination strategies for these new targeted therapies.

Keywords: Ibrutinib; Idelalisib; Small molecule inhibitors; Venetoclax.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use*
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Biomarkers
  • Drug Resistance, Neoplasm
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukemia, Lymphocytic, Chronic, B-Cell / etiology
  • Leukemia, Lymphocytic, Chronic, B-Cell / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell / mortality
  • Lymphoma, Non-Hodgkin / drug therapy*
  • Lymphoma, Non-Hodgkin / etiology
  • Lymphoma, Non-Hodgkin / metabolism
  • Lymphoma, Non-Hodgkin / mortality
  • Molecular Targeted Therapy*
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Receptors, Antigen, B-Cell / metabolism
  • Retreatment
  • Signal Transduction / drug effects
  • Treatment Outcome

Substances

  • Antineoplastic Agents
  • Biomarkers
  • Protein Kinase Inhibitors
  • Receptors, Antigen, B-Cell