Chronic Lymphocytic Leukemia

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Anas Younes, MD, chief, Lymphoma Service, Memorial Sloan Kettering Cancer Center, discusses treatment with idelalisib for chronic lymphocytic leukemia (CLL) and indolent non-Hodgkin lymphoma (iNHL)

Idelalisib is a potent and highly selective PI3K inhibitor that promotes apoptosis in primary cells from patients with different B-cell malignancies. Idelalisib has been shown to affect microenvironmental signaling and cell survival both in vitro and in vivo.

A combination of rituximab (Rituxan) and the PI3K-delta inhibitor idelalisib was associated with a >70% improvement in overall survival (OS) in patients with high-risk relapsed/refractory chronic lymphocytic leukemia (CLL).

At the 55th Annual Meeting of the American Society of Hematology (ASH), several trials of ibrutinib both alone and in combination with currently used therapies for patients with chronic lymphocytic leukemia (CLL) were presented.

In patients with previously untreated chronic lymphocytic leukemia (CLL) who are considered inappropriate for fludarabine, the addition of ofatumumab to chlorambucil improves clinical outcomes and is tolerable irrespective of patient age or fitness.

According to preliminary results of a phase I clinical trial, nearly half of patients with relapsed or refractory CLL attained objective responses when treated with IPI-145, an oral inhibitor of PI3K-delta and -gamma.

A randomized trial showed that patients with CLL and major comorbidities had significantly better outcomes when treated with obinutuzumab, an anti-CD20 monoclonal antibody, instead of rituximab.