Signalling to drug resistance in CLL

The nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kappa B) signalling pathway is constitutively active in a variety of cancers, including chronic lymphocytic leukaemia (CLL). The importance of this signalling pathway identifies it as a prime therapeutic target; however, the complexity and potential side effects of inhibiting NF-kappa B have thus far made the clinical use of NF-kappa B inhibitors a relatively unexplored resource in this disease. This article discusses the role of NF-kappa B in CLL as a common crossroad for pathways promoting drug resistance in CLL. We provide the background on how this pathway contributes to both spontaneous and drug-induced apoptosis. Potential new avenues to regulate this pathway in CLL are also discussed. (C) 2010 Elsevier Ltd. All rights reserved.