Journal
JOURNAL OF GERIATRIC ONCOLOGY
Volume 7, Issue 5, Pages 375-382Publisher
ELSEVIER SCIENCE BV
DOI: 10.1016/j.jgo.2016.07.007
Keywords
Chronic lymphocytic leukemia; Chemoimmunotherapy; Kinase inhibitors; BCL2 inhibitor
Categories
Funding
- Roche
- Glaxo Smith Kline
- Mundipharma
- Janssen
- Gilead
- Celgene
- Bristol Myers Squibb
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The majority of patients with chronic lymphocytic leukemia (CLL) are over 70 years old. These patients vary in their vulnerability toward treatment efforts. Heterogeneity in fitness of older patients with CLL is mainly determined by individual differences in physiological aging and pathological conditions such as comorbidities and geriatric syndromes. Various options exist to treat older patients with CLL outside and inside clinical trials. Among these are new treatment approaches, including chemoimmunotherapy with engineered CD20 antibodies (e.g., obinutuzumab), single agent therapy with Icinase inhibitors (e.g., ibrutinib, idelalisib), other targeted drug therapy (e.g., venetoclax, lenalidomide), and combinations of these novel compounds. Treatment recommendations for older patients take patient-related as well as disease-related risk factors into consideration. Emerging new treatment approaches in older patients offer novel opportunities, but also novel challenges which are discussed in this review. (C) 2016 Elsevier Ltd. All rights reserved.
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