Ibrutinib in addition to rituximab is being developed for young and fit untreated patients with chronic lymphocytic leukaemia (CLL) or small lymphocytic lymphoma (SLL). CLL is a type of cancer in which too many white blood cells are produced. As these cells develop abnormally, they are unable to function, fight infection and reduce the production of healthy blood cells. The disease is chronic and develops slowly. Treatment for CLL is complex and depends on a number of factors, including the extent of disease, previous treatment, patient’s age, symptoms and general state of health. Patients whose CLL is not causing any symptoms or is getting worse only very slowly may not need treatment. Treatment for CLL is started only if symptoms become troublesome.
Ibrutinib works against cancerous B lymphocytes, which are a type of white blood cells affected by these diseases. It does this by blocking an enzyme called Bruton’s tyrosine kinase (BTK), which promotes survival of B lymphocytes and their migration to the organs where these cells normally divide. By blocking BTK, ibrutinib decreases the survival and migration of B lymphocytes, thereby delaying the progression of cancer. Ibrutinib is available in tablets taken orally. If licensed, ibrutinib in addition to rituximab will offer an additional first-line treatment option for untreated young and fit patients with CLL or SLL.
Carfilzomib, is a proteasome inhibitor. Proteasome is a system within the cells that breaks down proteins that are no longer needed. Cancer cells have an increased need to produce and break down proteins as they multiply rapidly. When carfilzomib stops the proteasome from breaking down proteins in the cancer cells, the proteins build up and cause the cells to die, slowing down the growth of the cancer. The addition of daratumumab and dexamethansone to carfilzomib may potentially improve outcomes and reduce side effects in patients with relapsed and/or refractory MM who have received prior therapies.