Researchers are developing newer drugs that specifically target the changes inside cells that cause them to become cancerous. Unlike standard chemotherapy drugs, which work by attacking rapidly growing cells in general (including cancer cells), these drugs attack one or more specific targets on or in cancer cells.
Ibrutinib (Imbruvica) is a targeted drug that can be used to treat chronic lymphocytic leukemia (CLL). It blocks the activity of a protein called a kinase that tells the leukemia cells to divide and helps them survive. This drug has been shown to help when CLL is hard to treat, for example, if there are chromosome 17 deletions or if CLL has come back after other treatments.
This drug is taken in pill form. Side effects tend to be mild, but can include diarrhea, nausea, constipation, fatigue, shortness of breath, swelling of the feet and hands, body aches, and rash. Low blood counts, including low red blood cell counts (anemia), low levels of certain white blood cells (neutropenia), and platelet counts (thrombocytopenia), are also common side effects. Some people treated with this drug get infections which can be serious. Other side effects can also be seen, so ask your doctor what you can expect.
Idelalisib (Zydelig) is another targeted drug for CLL. It blocks a kinase protein called PI3K. This drug has been shown to help treat CLL after other treatments have been tried. It is taken as a pill twice a day.
Common side effects include diarrhea, fever, fatigue, nausea, cough, pneumonia, belly pain, chills, and rash. Low blood counts, including low red blood cell counts (anemia), low levels of certain white blood cells (neutropenia), and platelet counts (thrombocytopenia), are also common. Less often, more serious side effects can occur, such as liver damage, severe diarrhea, lung inflammation (pneumonitis), serious allergic reactions, severe skin problems, and holes (perforations) in the intestines.
Venetoclax (Venclexta) is a drug that targets BCL-2, a protein in CLL cells that helps them survive longer than they should. This drug is used in patients whose CLL cells have a chromosome 17p deletion, typically after at least one other treatment has been tried. It is taken as a pill once a day.
Side effects can include low levels of certain white blood cells (neutropenia), low red blood cell counts (anemia), diarrhea, nausea, respiratory infections (such as colds), low platelet counts (thrombocytopenia), and feeling tired. Less common but more serious side effects can include pneumonia and other serious infections, and tumor lysis syndrome (in which many leukemia cells break open and spill their contents into the body).
For more information about targeted therapy, see Targeted Therapy.
Last Revised: 04/11/2016