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2017 ; 11
(ä): 685-694
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Development of venetoclax for therapy of lymphoid malignancies
#MMPMID28331288
Zhu H
; Almasan A
Drug Des Devel Ther
2017[]; 11
(ä): 685-694
PMID28331288
show ga
B-cell lymphoma-2 (BCL-2) family dysfunction and impairment of apoptosis are
common in most B-cell lymphoid malignancies. Venetoclax (Venclexta?, formerly
ABT-199, GDC-0199) is a highly selective BCL-2 inhibitor, which mimics its BCL-2
homology 3-domain to induce apoptosis. It was approved for treatment of
previously treated chronic lymphocytic leukemia (CLL) patients with 17p deletion
early in 2016. It has also been in clinical trials for other B-cell lymphoid
malignancies. Unlike the other recently approved targeted agents idelalisib and
ibrutinib, so far there has been no relapse reported in some patients. Also,
unlike the other targeted agents, it is effective against tumor cells that reside
in the blood marrow. Despite its promising outcome in CLL, preclinical data have
already uncovered mechanistic insights underlying venetoclax resistance, such as
upregulation of MCL-1 or BCL-xL expression and protective signaling from the
microenvironment. In this review, we describe the role of the BCL-2 family in the
pathogenesis of B-cell lymphoid malignancies, the development of venetoclax, and
its current clinical outcome in CLL and other B-cell malignancies. We also
discuss the resistance mechanisms that develop following venetoclax therapy,
potential strategies to overcome them, and how this knowledge can be translated
into clinical applications.
|Antineoplastic Agents/chemical synthesis/chemistry/*therapeutic use
[MESH]
|Bridged Bicyclo Compounds, Heterocyclic/chemical synthesis/chemistry/*therapeutic
use
[MESH]