The potential combination of BCL-2 inhibitors and ibrutinib as frontline therapy in chronic lymphocytic leukemia

Leuk Lymphoma. 2017 Oct;58(10):2287-2297. doi: 10.1080/10428194.2017.1312387. Epub 2017 May 9.

Abstract

The recent development of small molecule inhibitors targeted at the B-cell receptor (BCR) pathway and the anti-apoptotic protein BCL-2 has revolutionized the care of patients with chronic lymphocytic leukemia (CLL). While durable responses to the BCR inhibitor ibrutinib have been observed in both previously untreated and relapsed/refractory CLL patients, residual disease is common in patients treated with single-agent ibrutinib. Interest remains high in therapeutic combinations that may lead to better quality remissions. A potential partner to ibrutinib with a distinct mechanism of action that is likely to lead to deeper responses is the BCL-2 inhibitor venetoclax. Preclinical studies have suggested synergism between inhibitors of BCR and BCL-2 and have paved the way to the development of ongoing clinical trials aimed at evaluating the combination of ibrutinib with venetoclax in CLL patients.

Keywords: BCL-2; Chronic lymphocytic leukemia; combination therapy; ibrutinib; venetoclax.

MeSH terms

  • Adenine / analogs & derivatives
  • Antineoplastic Combined Chemotherapy Protocols* / therapeutic use
  • Apoptosis / drug effects
  • Humans
  • Leukemia, Lymphocytic, Chronic, B-Cell* / drug therapy
  • Piperidines
  • Proto-Oncogene Proteins c-bcl-2* / antagonists & inhibitors
  • Pyrazoles* / therapeutic use
  • Pyrimidines* / therapeutic use

Substances

  • Piperidines
  • Proto-Oncogene Proteins c-bcl-2
  • Pyrazoles
  • Pyrimidines
  • ibrutinib
  • Adenine