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Journal of Internal Medicine
Article . 2017 . Peer-reviewed
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Targeting of B‐cell receptor signalling in B‐cell malignancies

Authors: M. Jerkeman; M. Hallek; M. Dreyling; C. Thieblemont; E. Kimby; L. Staudt;

Targeting of B‐cell receptor signalling in B‐cell malignancies

Abstract

AbstractPharmacological agents that inhibit enzymes of the B‐cell receptor (BCR) pathway are of increasing importance in the treatment of B‐cell malignancies. These include inhibitors of Bruton tyrosine kinase (BTK), phosphatidylinositol 3‐kinase (PI3K), splenic tyrosine kinase and protein kinase Cβ. Two agents are already approved in the USA and Europe: ibrutinib, a BTK inhibitor, for the treatment of chronic lymphatic leukaemia (CLL), mantle cell lymphoma (MCL) and Waldenström's macroglobulinemia; and idelalisib, a PI3Kδ inhibitor, for the treatment of CLL and follicular lymphoma. In addition, the role of these drugs in diffuse large B‐cell lymphoma and marginal zone lymphoma is under investigation, as single agents and in combination with chemotherapy. In CLL, both ibrutinib and idelalisib have an established role as first‐line therapy in patients with del(17p), and in MCL, ibrutinib is a standard option for patients relapsing after chemoimmunotherapy. Unexpected toxicities have been encountered when combining these potent new agents with other drugs, including chemotherapy and lenalidomide, and based on this experience the risks and benefits of novel combinations must be evaluated carefully. In this review, we summarize the efficacy and safety results with these inhibitors and discuss novel combinations that are under study and the future role of BCR inhibitors in these disorders.

Country
Sweden
Keywords

Lymphoma, Adenine, Receptors, Antigen, B-Cell, Hematology, Lymphoma, Mantle-Cell, Protein-Tyrosine Kinases, Leukemia, Lymphocytic, Chronic, B-Cell, Pyrimidines, Piperidines, Purines, B-cell receptor, Antineoplastic Combined Chemotherapy Protocols, Agammaglobulinaemia Tyrosine Kinase, Leukemia, B-Cell, Leukaemia, Humans, Pyrazoles, Waldenstrom Macroglobulinemia, Quinazolinones

  • BIP!
    Impact byBIP!
    citations
    This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    39
    popularity
    This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
    Top 10%
    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
    Top 10%
    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
    Top 10%
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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
39
Top 10%
Top 10%
Top 10%
Green
bronze