한빛사 논문
Inhye E. Ahn, M.D. Xin Tian, Ph.D. Adrian Wiestner, M.D., Ph.D.
National Heart, Lung, and Blood Institute Bethesda, MD
Corresponding author: Adrian Wiestner, M.D., Ph.D.
Abstract
To the Editor:
Targeted agents replace chemoimmunotherapy for most patients with chronic lymphocytic leukemia (CLL). In randomized trials of ibrutinib or venetoclax, the risk of progression or death in patients with CLL was up to 75% lower than that with chemoimmunotherapy.1-3 Venetoclax-based, fixed-duration regimens led to high rates of undetectable minimal residual disease (MRD).3 These findings contrast with those for continuous treatment with Bruton’s tyrosine kinase (BTK) inhibitors, including ibrutinib, which have been associated with a durable response despite low rates of undetectable MRD. The presence of a tumor protein p53 (TP53) mutation or 17p deletion predicts an increased risk of relapse and death after chemoimmunotherapy. However, the durability of the response to targeted therapy in previously untreated patients with TP53 alterations is ill defined.
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