The role of Bruton’s kinase inhibitors (BTKi) in accelerated Chronic Lymphocytic Leukemia (a-CLL): a case of successful response to acalabrutinib
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Gioacchino Catania
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Rita Tavarozzi
Abstract
Objectives
The use of Bruton’s tyrosine kinase (BTK) inhibitors has changed the clinical history of patients with chronic lymphocytic leukemia (CLL) in both naïve and relapsed/refractory settings. “Accelerated” chronic lymphocytic leukemia (a-CLL) is a relatively rare form of CLL representing less than 1 % of all CLL cases. a-CLL patients usually have a more aggressive course and a reduced overall survival was reported with conventional chemo-immunotherapy approaches.
Methods
The role of Bruton Tyrosine Kinase-inhibitor, ibrutinib, in a-CLL is well established with encouraging preliminary results.
Results
We report a case of a-CLL-treated first-line with second-generation BTKi, acalabrutinib with a prompt clinical response. As known, it is the first literature report on acalabrutinib in a-CLL highlighting the role of second-generation BTKi also in this high-risk setting.
Conclusions
Target therapies (Bruton Kinase inhibitors and Bcl2 inhibitors) have improved the therapeutic landscape of CLL. The availability of therapeutic targets requires greater diagnostic accuracy to choose the most appropriate therapy for each patient.
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Research funding: None declared.
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Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
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Competing interests: Authors state no conflict of interest.
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Informed consent: Not applicable.
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Ethical approval: Not applicable.
References
1. Kipps, TJ, Stevenson, FK, Wu, CJ, Croce, CM, Packham, G, Wierda, WG, et al.. Chronic lymphocytic leukaemia. Nat Rev Dis Prim 2017;3:16096. https://doi.org/10.1038/nrdp.2016.96.Suche in Google Scholar PubMed PubMed Central
2. Hallek, M. Chronic lymphocytic leukemia: 2020 update on diagnosis, risk stratification and treatment. Am J Hematol 2019;94:1266–87. https://doi.org/10.1002/ajh.25595.Suche in Google Scholar PubMed
3. THerndon, TM, Chen, SS, Saba, NS, Valdez, J, Emson, C, Gatmaitain, M, et al.. Direct in vivo evidence for increased proliferation of CLL cells in lymph nodes compared to bone marrow and peripheral blood. Leuk 2017;31:1340–7. https://doi.org/10.1038/leu.2017.11.Suche in Google Scholar PubMed PubMed Central
4. Gine, E, Martinez, A, Villamor, N, Lopez-Guillermo, A, Camos, M, Martinez, J, et al.. Expanded and highly active proliferation centers identify a histological subtype of chronic lymphocytic leukemia (“accelerated” chronic lymphocytic leukemia) with aggressive clinical behavior. Haematologica 2010;95:1526–33. https://doi.org/10.3324/haematol.2009.022277.Suche in Google Scholar
5. Xie, J, Jang, A, Vegel, A, Hajja, Y, Mouawad, Y, Baghiani, A, et al.. Successful treatment of “accelerated” chronic lymphocytic leukemia with single agent ibrutinib: a report of two cases. Leukemia Res Rep 2021;15:100247. https://doi.org/10.1016/j.lrr.2021.100247.Suche in Google Scholar PubMed PubMed Central
6. Robak, T, Witkowska, M, Smolewski, P. The role of Bruton’s kinase inhibitors in chronic lymphocytic leukemia: current status and future directions. Cancers 2022;14:771.10.3390/cancers14030771Suche in Google Scholar PubMed PubMed Central
7. Lewis, KL, Cheah, CYJ. Non-covalent BTK inhibitors-the new BTKids on the block for B-cell malignancies. Pers Med 2021;11:764. https://doi.org/10.3390/jpm11080764.Suche in Google Scholar PubMed PubMed Central
8. Mato, AR, Shah, NN, Jurczak, W, Cheah, CY, Pagel, JM, Woyach, JA, et al.. Pirtobrutinib in relapsed or refractory B-cell malignancies (BRUIN): a phase 1/2 study. Lancet 2021;397:892–901. https://doi.org/10.1016/s0140-6736(21)00224-5.Suche in Google Scholar PubMed
9. Binnerts, ME, Otipoby, KL, Hopkins, BT, Bohnert, T, Hansen, S, Jamieson, G, et al.. SNS-062 is a potent noncovalent BTK inhibitor with comparable activity against wide type BTK and BTK with an acquired resistance mutation. Mol Cancer Therapeut 2015;14:C186. https://doi.org/10.1158/1535-7163.targ-15-c186.Suche in Google Scholar
10. Shanafelt, TD, Wang, XV, Kay, NE, Curtis, A, O’Brien, S, Barrientos, J, et al.. Ibrutinib-rituximab or chemoimmunotherapy for chronic lymphocytic leukemia. N Engl J Med 2019;381:432–43.10.1056/NEJMoa1817073Suche in Google Scholar PubMed PubMed Central
11. Sharman, JP, Egyed, M, Jurczak, W, Skarbnik, A, Pagel, JM, Flinn, IW, et al.. Acalabrutinib with or without obinutuzumab versus chlorambucil and obinutuzmab for treatment-naive chronic lymphocytic leukaemia (ELEVATE .R.,TN): a randomised, controlled, phase 3 trial. Lancet 2020;395:1278–91. https://doi.org/10.1016/s0140-6736(20)30262-2.Suche in Google Scholar
12. Ghia, P, Pluta, A, Wach, M, Lysak, D, Kozak, T, Simkovic, M, et al.. ASCEND: phase III, randomized trial of acalabrutinib versus idelalisib plus rituximab or bendamustine plus rituximab in relapsed or refractory chronic lymphocytic leukemia. J Clin Oncol 2020;38:2849–61. https://doi.org/10.1200/jco.19.03355.Suche in Google Scholar
13. Byrd, JC, Hillmen, P, Ghia, P, Kater, AP, Chanan-Khan, A, Furman, R, et al.. Acalabrutinib versus ibrutinib in previously treated chronic lymphocytic leukemia: results of the first randomized phase III trial. J Clin Oncol 2021;39:3441–52. https://doi.org/10.1200/jco.21.01210.Suche in Google Scholar
14. Condoluci, A, Rossi, D. Biology and treatment of Richter transformation. Front Oncol 2022;12:829983. https://doi.org/10.3389/fonc.2022.829983.Suche in Google Scholar PubMed PubMed Central
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Artikel in diesem Heft
- Frontmatter
- Editorial
- Investigating periprostatic adipose tissue as a driving force of prostate cancer progression: a new source of information for the advancement of targeted therapy in metastatic prostate cancer
- Reviews
- Pathophysiological effects of cadmium(II) on human health-a critical review
- The role of synbiotics in improving inflammatory status in nasopharyngeal carcinoma patients
- Anti-ageing effects of FDA-approved medicines: a focused review
- Diagnosis and management of uterine fibroids: current trends and future strategies
- Importance of moderate-to-vigorous physical activity during the COVID-19 pandemic: a systematic review and meta-analysis
- Original Articles
- Healthcare workers’ knowledge of evidence-based guidelines for prevention of ventilator-associated pneumonia in Hodeida, Yemen
- Comparison of cardiac autonomic function across complete glycaemic spectrum
- Prognostic value of heart rate variability in acute coronary syndrome
- Insights into the protective capacity of human dental pulp stem cells and its secretome in cisplatin-induced nephrotoxicity: effects on oxidative stress and histological changes
- Caffeine impairs anticonvulsant effects of levetiracetam in the maximal electroshock seizure threshold test in mice
- Antioxidant activity in off and on-pump coronary artery bypass grafting and valve replacement surgery
- A drug utilisation pattern in non-dialysis patients of diabetic nephropathy in a government-run tertiary care hospital in South-Asia
- Inguinal lymphadenectomy in penile cancer patients: a comparison between open and video endoscopic approach in a multicenter setting
- A randomized controlled trial to evaluate the efficacy of electrical vestibular nerve stimulation (VeNS), compared to a sham control for the management of sleep in young adults
- Short Communication
- The role of Bruton’s kinase inhibitors (BTKi) in accelerated Chronic Lymphocytic Leukemia (a-CLL): a case of successful response to acalabrutinib
- Letter to the Editor
- A hypothesis that Notopterol may be effective in COVID-19 via JAK/STAT and other signaling pathways
