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10.2147/TCRM.S73559

http://scihub22266oqcxt.onion/10.2147/TCRM.S73559
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suck abstract from ncbi


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pmid26150724
      Ther+Clin+Risk+Manag 2015 ; 11 (ä): 979-90
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  • A critical appraisal of ibrutinib in the treatment of mantle cell lymphoma and chronic lymphocytic leukemia #MMPMID26150724
  • Tucker DL ; Rule SA
  • Ther Clin Risk Manag 2015[]; 11 (ä): 979-90 PMID26150724 show ga
  • Although chemo-immunotherapy remains at the forefront of first-line treatment for mantle cell lymphoma (MCL) and chronic lymphocytic leukemia (CLL), small molecules, such as ibrutinib, are beginning to play a significant role, particularly in patients with multiply relapsed or chemotherapy-refractory disease and where toxicity is an overriding concern. Ibrutinib is a first-in-class, oral inhibitor of Bruton's tyrosine kinase, which functions by irreversible inhibition of the downstream signaling pathway of the B-cell receptor, which normally promotes cell survival and proliferation. Early clinical trials have demonstrated excellent tolerability and a modest side-effect profile even in elderly and multiply pretreated patient cohorts. Although the majority of disease responses tend to be partial, efficacy data have also been encouraging with more than two-thirds of patients with CLL and MCL demonstrating a durable response, even in the high-risk disease setting. Resistance mechanisms are only partially understood and appear to be multifactorial, including the binding site mutation C481S, and escape through other common cell-signaling pathways. This article appraises the currently available data on safety and efficacy from clinical trials of ibrutinib in the management of MCL and CLL, both as a single agent and in combination with other therapies, and considers how this drug is likely to be used in future clinical practice.
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