PARADIGM SHIFT IN HEMATOLOGIC MALIGNANCY
"NO MORE CHEMOTHERAPY"
FROM A DISCUSSION BY DR BRUCE CHESON, GEORGETOWN UNIVERSITY.
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1.IBRUTINIB

-A Bruton Thyrokinase Inhibitor, working downstream B Cell Receptor
-active in Indolent lymphoma, showing 40% Response Rates in relapse / refractory setting where Activated B cell B  (ABC) phenotype is expressed.
-Here also Revlimid is being used
-and now being tried in Follicular lymphoma
-It is being given in combination with or after failure of Bendamustine and Rituxan.

2.IDELALISIB

-It is an inhibitor of PI3 kinase (in its Delta form)
-shows significant Activity in Indolent Lymphoma, CLL, and Mantle cell
-It is given after or in lieu of HYPERCVAD in Mantle cell lymphoma

3. BRENTUXIMAB VEDOTIN

-AN ANTIBODY CONJUGATE
-Indicated in Hodgkin Lymphoma, Anaplastic large cell lymphoma, CD 30 positive, and may have activity in Diffuse Large cell Lymphoma

No chemotherapy needed, and certain of these products have minimal Thrombocytopenic side effects, allowing easy combination with other drugs!