Critical Molecular Pathways in CLL Therapy

[cllady01]

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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NOTE: post is not locked, so do not want to reply with any personal information.

[Name-1]

Thank you clllady

[cllady01 Former Volunteer in reply to Name-1]

You are most welcome, Olga. I hope you are keeping well. We still have 90 degree days and dreadful humidity---local weather lady said we could look forward for more of that in "Hotober"

[Smakwater]

Lots of good stuff here cllady, and very clearly written.

I'm going to have to revisit this a few times.

JM

[JigFettler Volunteer]

Nice Link, thank you I will store that one.

Its a good summary of CLL and BTK Inhibitor activity.

All best wishes

Jig