Dr. Susan O'Brien on Next-Generation Small Molecules in CLL

Susan O’Brien, MD, Associate Director for Clinical Science for the Chao Family Comprehensive Cancer Center and Medical Director of the Sue and Ralph Stern Center for Cancer Clinical Trials and Research, UC Irvine Health, discusses upcoming agents in chronic lymphocytic leukemia (CLL).

Approved CLL agents, ibrutinib, a BTK-inhibitor and idelalisib, a PI3K-inhibitor, both target the b-cell receptor. There is another enzyme in that pathway known as SIK that can also be targeted, but there are currently no commercially available agents, says O’Brien.

There are several next-generation BTK- PI3K-, and SIK-inhibitors currently in clinical trials. The agent closest to potentially being approved is duvelisib, a PI3K-inhbiitor, says O’Brien. If its study is positive, it could potentially be available in the next two years, she says.

It will have to be determined if these next-generation agents are better than what is currently available. Agents that demonstrate improved efficacy and less toxicities are needed, says O’Brien.