Although there have been significant advancements in the treatment of patients with chronic lymphocytic leukemia (CLL) during the past decade, oncologists and hematologists were missing a tool that has become increasingly available for attacking other malignancies: an oral small-molecule inhibitor.
In this issue, we’re happy to report
not only that the approval of ibrutinib (Imbruvica) means that such an agent is now available for treating certain patients with CLL, but also that several classes of molecularly targeted drugs are in development.
In short, management of patients with CLL is entering a new era of precision medicine.
We’re using that term as a more definitive and, we hope, more meaningful description for oncology therapeutics aimed at specific cellular processes. In every tumor type, the introduction of therapies that can mount a more precise attack on the underlying biological processes of cancer has been a milestone for progress.
An important next step has been the consideration of biomarkers that may indicate which patients are optimal candidates for a new agent.
Elsewhere in this issue, we relate the story of how such progress was achieved in another hematologic malignancy, chronic myeloid leukemia (CML). Brian J. Druker, MD, tenaciously pursued the concept that a small molecule that inhibits the tyrosine kinase created by the Philadelphia chromosomal abnormality in CML would be a successful strategy for attacking the malignancy. The result was a therapy that many observers say has helped change the natural history of CML and has paved the way for other tyrosine kinase inhibitors.
It is much too soon to predict what kind of an impact the new agents in development for CLL will have on patients with the disease. There is much excitement over the clinical benefit and quality-of-life improvements that some patients are experiencing already as a result of ibrutinib therapy.
We do know that practicing oncologists carefully weigh multiple factors before administering a new therapy to a patient.
We hope the material in this issue provides information that helps you ponder the options— thoughtfully and with precision.
As always, thank you for reading.