Targeted therapy for chronic lymphocytic leukemia
Targeted therapy is sometimes used to treat chronic lymphocytic leukemia (CLL). It uses drugs to target specific molecules (such as proteins) on the surface of cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. Targeted therapy may also be called molecular targeted therapy.
You may have targeted therapy:
- to treat intermediate-risk or high-risk CLL
- when CLL no longer responds to standard chemotherapy treatments
Your healthcare team will consider your personal needs to plan the drugs, doses and schedules of targeted therapy. You may also receive other treatments.
Targeted therapy drugs commonly used for CLL @(Model.HeadingTag)>
Targeted therapy may be given in combination with chemotherapy drugs. The most common targeted therapy drugs used are:
- rituximab (Rituxan)
- alemtuzumab (Campath)
- ofatumumab (Arzerra)
- obinutuzumab (Gazyva)
- ibrutinib (Imbruvica)
- idelalisib (Zydelig)
- venetoclax (Venclexta)
Rituximab, ofatumumab and obinutuzumab are given by a needle in a vein (intravenously). Alemtuzumab is given either intravenously or by an injection just under the skin (called subcutaneous, or SC, injection). Ibrutinib is given as a capsule by mouth. Idelalisib and venetoclax are given as a tablet by mouth.
Side effects @(Model.HeadingTag)>
Side effects can happen with any type of treatment for CLL but everyone’s experience is different. Some people have many side effects. Other people have few or none at all.
Targeted therapy doesn’t usually damage healthy cells, so it tends to cause fewer and less severe side effects than chemotherapy and radiation therapy. Chemotherapy and radiation therapy can damage healthy cells along with cancer cells.
If side effects develop with targeted therapy, they can happen any time during, immediately after or a few days or weeks after targeted therapy. Sometimes late side effects develop months or years after targeted therapy. Most side effects go away on their own or can be treated, but some side effects may last a long time or become permanent.
Side effects of targeted therapy will depend mainly on the type of drug, the dose, and your overall health. Some common side effects of targeted therapy for CLL are:
- flu-like symptoms, such as fever and chills
- nausea and vomiting
- skin problems, including redness, itching and dryness
- low blood cell counts (called bone marrow suppression)
- allergic reactions
- tumour lysis syndrome (venetoclax)
Tell your healthcare team if you have these side effects or others you think might be from targeted therapy. The sooner you tell them of any problems, the sooner they can suggest ways to help you deal with them.
Information about specific cancer drugs @(Model.HeadingTag)>
American Cancer Society. Leukemia - Chronic Lymphocytic. Atlanta, GA: American Cancer Society; 2013: http://www.cancer.org/acs/groups/cid/documents/webcontent/003111-pdf.pdf.
American Society of Clinical Oncology (ASCO). Leukemia - Chronic Lymphocytic - CLL: Treatment Options. Alexandria, VA.: American Society of Clinical Oncology (ASCO); 2014: http://www.cancer.net/cancer-types/leukemia-chronic-lymphocytic-cll/treatment-options.
Borthakur G, O'Brien S . Treatment of chronic lymphocytic leukemia and related disorders. Wiernik PH, Goldman JM, Dutcher JP & Kyle RA (eds.). Neoplastic Diseases of the Blood. 5th ed. Springer; 2013: 9: pp. 121-119.
Drugs and Health Products. Qualifying Notice for Venclexta. Health Canada; 2016: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/notices-avis/conditions/venclexta-qn-aa-190761-eng.php.
Health Canada. Drugs and Health Products: Gazyva. Ottawa, ON: Health Canada; 2015: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/drug-med/sbd_smd_2015_gazyva_168227-eng.php.
Health Canada. Drugs and Health Products: Imbruvica. Ottawa, ON: Health Canada; 2015: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/sbd-smd/drug-med/sbd_smd_2015_imbruvica_174029-eng.php.
Health Canada. Drugs and Health Products: Zydelig. Ottawa, ON: Health Canada; 2015: http://www.hc-sc.gc.ca/dhp-mps/prodpharma/notices-avis/conditions/zydelig_dhcpl_lapds_172652-eng.php.
Mir Muhammad A . Chronic lymphocytic leukemia treatment & management. eMedicine.Medscape.com. WebMD LLC; 2014.
Wierda WG, O'Brien S . Chronic lymphocytic leukemia. DeVita VT Jr, Lawrence TS, & Rosenberg SA. Cancer: Principles & Practice of Oncology. 9th ed. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2014: 134: pp. 1973-1987.