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Dr. Adrian Wiestner of the NIH not only does important clinical trials but also does important bench science on what makes chronic lymphocytic leukemia (CLL) cells survive.
Take Away Points:
- B cell receptors (BCR) are the “raison d’etre” of all B cells. They live to get stimulated by the BCR and then go into action to mature and form antibodies to defend us against threats, such as infections
- In CLL, BCRs tell the CLL cells to survive, but they don’t mature into plasma cells that form antibodies, as do healthy B cells.
- Blocking BCR has led to game-changing advances in treating CLL including approved medications such as ibrutinib and idelalisib, as well as other drugs under investigation, such as acalabrutinib, duvelisib, BGB-3111, ONO-4059, TGR-1202, SNS-062 and others
- CLL cells are also stimulated to grow and survive by Toll Like Receptors (TLRs)
- TLR are important in auto-immune processes
- Ibrutinib blocks not just BCR but also TLRs which is good news because it suggests that it may block a whole web of signals that can help CLL.
This interview covers much basic science, but it was research such as this that first focused the research community and the pharmaceutical industry on BCR as a target in CLL. And the rest is history.
Please enjoy our interview.
Brian Koffman, MD 11/14/16