The future of antibody therapy in chronic lymphocytic leukemia

ABSTRACT

Introduction

Outcomes in chronic lymphocytic leukemia (CLL) have been dramatically improved with the addition of anti-CD20 antibodies to chemotherapy, defining a new standard of care for many years. More recently, therapies targeting fundamental signaling and anti-apoptotic pathways within the CLL cell have demonstrated dramatic clinical responses, including in patients with high-risk prognostic markers, thus emerging as preferred therapy for many patients. While the addition of anti-CD20 antibodies to traditional chemotherapy resulted in significant improvements in outcomes, the role of monoclonal antibodies in the era of targeted agents remains an active area of investigation. Furthermore, since the advent of next-generation anti-CD20 antibodies, the role of specific anti-CD20 antibodies remains an open question.

Areas covered

In this review, we highlight the important role that anti-CD20 antibody therapy has had in the field of CLL, both when used with chemotherapy and in combination with targeted therapy, as well as the current studies that are further exploring this treatment paradigm in the modern era.

Expert opinion

While anti-CD20 antibodies have played a pivotal role in the treatment of CLL, additional studies will be required to determine the optimal application of these therapies in combination with targeted therapy.

KEYWORDS:

• CLL
• anti-cd20 antibodies
• rituximab
• obinutuzumab
• targeted therapy

Declaration of interest

JL Crombie: consultant for Incyte and Karopharm; research funding from Bayer and Abbvie. JR Brown: consultant for Abbvie, Acerta, Astra-Zeneca, Beigene, Catapult, Dynamo, Therapeutics, Eli Lilly, Juno/Celgene, Kite, MEI Pharma, Nextcea, Novartis, Octapharma, Pfizer, Rigel, Sunesis, TG Therapeutics, Verastem; received honoraria from Janssen; received research funding from Gilead, Loxo, Sun and Verastem; and served on data safety monitoring committees for Invectys. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded. Jennifer Crombie is supported by NIH K12CA087723 and Jennifer Brown is supported by NIH 1R01CA213442.