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Frontline Therapy of Chronic Lymphocytic Leukemia: Changing Treatment Paradigm

  • Chronic Lymphocytic Leukemias (N Jain, Section Editors)
  • Published:
Current Hematologic Malignancy Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The treatment landscape of treatment-naive chronic lymphocytic leukemia (TN-CLL) is rapidly evolving. As more and more new drugs and combinations are becoming part of therapeutic armamentarium, it becomes highly pertinent to understand the evidence for each of the treatment options to select the right drug for the right patient. We summarize the recent data of the available frontline treatment options.

Recent Findings

The novel agents can overcome adverse biological attributes and provide long-term disease control. MRD may become a reliable surrogate for survival in the evaluation of future therapies. FCR still remains one of the best options in a young fit CLL with mutated IGVH. Long-term follow-up data of ibrutinib confirm its efficacy and safety in both high-risk and elderly TN-CLL patients. A combination of venetoclax with obinutuzumab has provided the hope of fixed-duration therapy and the potential for functional cure in TN-CLL. Several other trials testing the efficacy of other targeted agents and the optimal sequencing approaches are underway.

Summary

Chemoimmunotherapy holds its ground as an effective treatment in the IGVH-mutated CLL. The targeted agents either singly or in combination have become standard of care in many subsets of TN-CLL.

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Authors and Affiliations

  1. Adult Hematolymphoid Unit, Tata Memorial Centre, Affiliated to Homi Bhabha National University, E Borges Road, Mumbai, 400 012, Maharashtra, India

    Manju Sengar, Hasmukh Jain & Jayashree Thorat

  2. Medical Oncology, Tata Memorial Centre, Affiliated to Homi Bhabha National University, E Borges Road, Mumbai, 400 012, Maharashtra, India

    Akhil Rajendra & Karthik Rengaraj

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  1. Manju Sengar
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Correspondence to Manju Sengar.

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Sengar, M., Jain, H., Rajendra, A. et al. Frontline Therapy of Chronic Lymphocytic Leukemia: Changing Treatment Paradigm. Curr Hematol Malig Rep 15, 168–176 (2020). https://doi.org/10.1007/s11899-020-00580-7

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