Les chercheurs continuent d’étudier les signaux des cellules (la communication de l’information à l’intérieur de la cellule et entre les cellules), un processus qui contribue à la croissance et à la survie des cellules cancéreuse. Certains médicaments sont actuellement créés pour bloquer ces signaux et interrompre la croissance et la propagation des cellules touchées par la LLC, tout en limitant les dommages causés aux cellules normales.

Un grand nombre de nouvelles thérapies ciblées font actuellement l’objet d’essais cliniques, et certaines ont récemment été approuvées pour le
traitement de la LLC. Parmi ces thérapies ciblées, plusieurs sont disponibles sous forme de comprimés, permettant ainsi aux patients de prendre leurs médicaments
à la maison.

La plupart des thérapies ciblées affectent la moelle osseuse; il peut donc y avoir un risque d’infections et de saignements. De nombreux patients éprouvent de la fatigue, parfois des nausées ou des troubles intestinaux. Certains médicaments peuvent également être la cause de neuropathies périphériques (voir description sous « effets secondaires de la chimiothérapie »).

Currently, the drugs ibrutinib, idelalisib and venetoclax are the only targeted therapies approved by Health Canada for the treatment of patients with CLL.

Ibrutinib (Imbruvica®)

Ibrutinib is a drug that attaches directly to a protein called Bruton’s tyrosine kinase (BTK), which is very active in CLL cells. BTK sends signals in the cell to help it grow and survive. Ibrutinib blocks the signals from BTK, which helps stop or slow down the division and survival of CLL cells.

Ibrutinib comes in pills (tablets) that must be taken every day.

Ibrutinib has been approved by Health Canada for treatment of the following patients with CLL:

  1. Previously untreated CLL with 17p deletion.
  2. Previously untreated CLL and not considered appropriate for treatment with a fludarabine-based regimen.
  3. Those who have received at least one prior therapy and are not considered appropriate for treatment or re-treatment with a fludarabine-based regimen (ibrutinib alone or in combination with bendamustine and rituximab).

Ibrutinib is currently reimbursed by some public and private drug insurance programs in Canada. Janssen offers a patient support program for those being treated with ibrutinib and, in some cases, for those who need assitance to access ibrutinib. You can find out more here or you can email imbruvica@bioadvancemail.ca.

Find information on potential side effects here.

Idelalisib (Zydelig®)

Idelalisib is a drug that blocks the signals from a protein called phosphoinositide 3-kinase (PI3K)-delta. The main job of PI3K-delta is to send signals that help B cell grow, divide and survive. By blocking the signal from PI3K-delta, idelalisib helps stop or slow down the growth of CLL and SLL cells.

Idelalisib comes in pills (tablets) that must be taken every day.

Idelalisib has been approved by Health Canada for treatment of the following patients with CLL:

  1. In combination with rituximab for those who have received at least one prior treatment.

Idelalisib is currently reimbursed by some public and private drug insurance programs in Canada. For information about access to idelalisib, contact the Gilead Oncology Patient Support Program: 1-844-453-6777

Find information on potential side effects here.

Venetoclax (Venclexta®)

Venetoclax is a drug that attaches to a protein called b-cell lymphoma 2 (Bcl-2). Bcl-2 plays an important role in keeping cells alive by blocking the actions of proteins that cause cell death. By attaching to Bcl-2, venetoclax stops Bcl-2 from inhibiting cell death.

Venetoclax comes in pills (tablets) that must be taken every day.

Venetoclax has been approved by Health Canada for treatment of the following patients with CLL:

  1. Those with 17p deletion who have received at least one prior therapy.
  2. Those without 17p deletion who have received at least one prior therapy and for whom there are no other available treatment options.
  3. In combination with rituximab for those who have received at least one prior therapy.

Venetoclax monotherapy for 3rd-line treatment following BTKi failure is currently reimbursed by most public drug insurance programs in Canada, and is covered by some private insurance programs. For assistance with access to venetoclax, call the Abbvie Care Program: 1-844-346-6626

Find information on potential side effects here.