MEDICINE CABINET:
TYPES OF TREATMENT
In recent years, many drugs have been FDA-approved to treat chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL). It is important to understand what the different types of treatment are and have a general understanding of how each one works slightly differently to treat the condition.
Drugs that slow cancer growth by blocking the process that is needed for CLL and SLL cells to grow and survive.
BTK Inhibitors
- Pirtobrutinib (Jaypirca)
- Ibrutinib (Imbruvica)
- Acalabrutinib (Calquence)
- Zanubrutinib (Brukinsa)
PI3K Inhibitors
- Idelalisib (Zydelig)
- Duvelisib (Copiktra)
BCL-2 Inhibitors
- Venetoclax (Venclexta)
TARGETED
THERAPY
CHEMO-IMMUNOTHERAPY (CIT)
CHEMO-
IMMUNOTHERAPY
(CIT)
Years ago, chemotherapy was the only medication available to treat chronic lymphocytic leukemia (CLL) and small lymphocytic leukemia (SLL). As biomarker testing became available, it was discovered that chemotherapy rarely works for CLL and SLL, and this is especially true when deletion 17p, TP53 mutation, or unmutated IGVH are present.
Chemotherapy-based regimens should no longer be used to treat CLL / SLL.
There are many other FDA-approved targeted therapies that have now become the standard of care. This is because targeted therapies are much more effective in treating the cancer and cause far fewer side effects.
Chemotherapy
- Fludrabine
- Cyclophosphamide
- Bendamustine
- Chlorambucil
- Pentostatin
IMMUNOTHERAPY
Immunotherapy drugs are designed to attach to a protein on the surface of cancer cells (called CD20) which flag the cancerous CLL and SLL cells so they can be recognized and attacked by the immune system. This often results in rapid destruction of the cancerous cells.
Anti-CD20 drugs are rarely used alone to treat CLL or SLL. Instead, they are typically given in combination with other targeted therapies. This is because research shows that combining an anti-CD20 with another targeted therapy often results in longer and deeper periods of remission.
Immunotherapy
- Rituximab
- Obinutuzumab
CELLULAR THERAPY
CELLULAR
THERAPY
A special type of immunotherapy that uses cells, not drugs, to treat CLL and SLL.
HSCT (Hematopoietic Stem Cell Transplant)
CLL and SLL weaken immunity since the bone marrow makes too many abnormal white blood cells. HSCT (or bone marrow transplant) can provide a healthy new immune system to attack and even cure CLL and SLL.
CAR-T (Chimeric Antigen Receptor T-cell)
Trains the immune system to recognize and attack cancerous CLL and SLL cells.
COMBINATION THERAPY
Combining two or more different drug types is a strategy commonly used to treat cancer because it can result in higher rates of remission and delay disease resistance. There are several FDA-approved drug combinations used to treat CLL and SLL, and many combinations are currently being studied in clinical trials.
