A critical appraisal of ibrutinib in the treatment of mantle cell lymphoma and chronic lymphocytic leukemia.

摘要: Although chemo-immunotherapy remains at the forefront of first-line treatment for mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL), small molecules, such as ibrutinib, are beginning to play a significant role, particularly in patients with multiply relapsed or chemotherapy-refractory disease where toxicity is an overriding concern. Ibrutinib first-in-class, oral inhibitor Bruton’s tyrosine kinase, which functions by irreversible inhibition downstream signaling pathway B-cell receptor, normally promotes survival proliferation. Early clinical trials have demonstrated excellent tolerability modest side-effect profile even elderly pretreated patient cohorts. majority responses tend be partial, efficacy data also been encouraging more than two-thirds CLL MCL demonstrating durable response, high-risk setting. Resistance mechanisms only partially understood appear multifactorial, including binding site mutation C481S, escape through other common cell-signaling pathways. This article appraises currently available on safety from ibrutinib management CLL, both single agent combination therapies, considers how this drug likely used future practice.