This is an overview of where we are in CLL treatment and where the research may be most needed at this point in time. Lengthy, with good illus. and delineates targets of current treatments.
molmed.biomedcentral.com/ar...
Sorry, if this is a duplicate.
Conclusion
The pace at which the understanding of the biology of CLL has increased over the last two decades is impressive and it has opened the door to new treatment compounds that target specific disease pathways (i.e. BCRi and BCL2i). These agents are effective in disease settings (e.g. del17p/TP53mutations) where conventional chemo(immuno)therapy fails. As a result, treatment algorithms for CLL are changing. Hopefully, as other critical molecular pathways and their interactions (e.g. ROR1, NOTCH1 BAFF/APRIL, CXCR4/CXCL12, PD1/PDL1, Mcl-1, SYK, CDK9 and CSF1R) are unraveled, newer and more effective pathway inhibitors will appear and so on hold promise for an even more effective therapeutic armamentarium. The introduction of CLL pathways inhibitors, however, does not convey the end of chemo(immuno) therapy in the management of this form of leukemia, rather their combined use is a most promising strategy in CLL therapy. Pathway inhibitors pose some issues that deserve investigation: best treatment combinations (e.g. BCRi + BCL2i, monoclonal antibodies [and or cytotoxic agents] + pathway inhibitors); optimal dose and schedule (including treatment duration), identification of specific predictive factors, mechanisms of resistance to therapy, and how to overcome them are the most important questions to be addressed.
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Video interviews; CLL 'Hot Topics and Maturing Data' ASH 2019: Prof John Gribben, Prof Pete Hillmen, Dr George Follows & Dr Renata Walewska 
