Importance of Minimal Residual Disease in the Era of Targeted Therapies in Chronic Lymphocytic Leukemia.

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-01-01 Epub Date: 2023-10-30 DOI:10.1159/000534846

Othman Al-Sawaf

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引用次数: 0

Abstract

Background: The level of minimal residual disease (MRD), often binarized into detectable or undetectable MRD according to certain thresholds, is strongly associated with long-term outcomes after chemo- and chemoimmunotherapy.

Summary: Driven by our improved understanding of the biology of chronic lymphocytic leukemia (CLL), the recent decade has shown a shift from chemotherapy-based regimens to regimens based on targeted agents that exploit distinct biological vulnerabilities of CLL. These targeted agents can be broadly classified into inhibitors of Bruton tyrosine kinase (BTK) and BCL2 as well as CD20-directed antibodies. Depending on which agent and which combination of agents is used, the levels or status of MRD can have varying clinical relevance. This has implications on the prognosis after therapy as well as on possible strategies to guide treatment duration and intensity.

Key messages: This review summarizes the main discoveries related to MRD in the context of targeted therapies. Furthermore, it provides an overview on current hurdles and caveats related to the implementation of MRD in regular clinical care and summarize open research questions that need to be addressed with future clinical studies.

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MRD在CLL靶向治疗时代的重要性。

最小残留疾病（MRD）的水平，通常根据某些阈值二值化为可检测或不可检测的MRD，与化疗和化学免疫治疗后的长期结果密切相关。在我们对CLL生物学理解的提高的推动下，最近十年显示出从基于化疗的方案向基于靶向药物的方案的转变，这些靶向药物利用了CLL的不同生物学脆弱性。这些靶向药物可广泛分为布鲁顿酪氨酸激酶（BTK）和BCL2抑制剂以及CD20定向抗体。根据所使用的制剂和制剂的组合，MRD的水平或状态可能具有不同的临床相关性。这对治疗后的预后以及指导治疗持续时间和强度的可能策略都有影响。这篇综述总结了在靶向治疗的背景下与MRD相关的主要发现。此外，它概述了目前在常规临床护理中实施MRD的障碍和注意事项，并总结了未来临床研究需要解决的开放性研究问题。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.