Another treatment choice for chronic lymphocytic leukemia: the new generation of Bruton tyrosine kinase inhibitors
10.3760/cma.j.cn115356-20200423-00104
- VernacularTitle:慢性淋巴细胞白血病又一治疗选择：新一代Bruton酪氨酸激酶抑制剂
- Author:
Haiwen HUANG
1
;
Depei WU
Author Information
1. 苏州大学附属第一医院血液科 215006
- From:
Journal of Leukemia & Lymphoma
2020;29(8):449-452
- CountryChina
- Language:Chinese
-
Abstract:
The first-generation Bruton tyrosine kinase inhibitor (BTKi) ibrutinib significantly improved the survival and prognosis of patients with chronic lymphocytic leukemia (CLL), but its adverse reactions such as bleeding, infection, cardiovascular events, etc., limited the long-term compliance of patients. It has been considered that the new generation of BTKi could significantly reduce the adverse reactions caused by ibrutinib because of their higher selectivity and specificity. Among them, the efficacy and safety of acalabrutinib in untreated and relapsed/refractory patients with CLL have been confirmed in phase Ⅲ clinical trials. In addition, zanubrutinib and orelabrutinib, which were independently developed in China, have also been proven their preliminary safety and therapeutic effects in pre-clinical and phase Ⅰ and Ⅱ clinical trials, while the data from large phase Ⅲ clinical trials are still lacking. Currently, more BTKi are also under active exploration. The future therapeutic strategies of CLL may be converted to combining with a wide range of drugs to achieve the goal of drug discontinuation when minimal residual disease (MRD) is negative, or use MRD to guide the treatment. In this trend, the new generation of BTKi will provide more optimized options for the combination therapy regimens.
