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Emerging drugs for Waldenström's macroglobulinemia
Efstathios Kastritis1, Evangelos Terpos, Meletios A Dimopoulos
1University of Athens School of Medicine, Department of Clinical Therapeutics, 80 Vas. Sofias Ave, 115 28, Athens, Greece.
Expert Opinion on Emerging Drugs
|March 1, 2011
Summary
New treatments for Waldenström's macroglobulinemia (WM) show promise, including proteasome inhibitors and targeted therapies. Combinations with existing drugs increase response rates, but long-term survival and toxicity require further study.
Area of Science:
- Hematology
- Oncology
- Pharmacology
Background:
- Waldenström's macroglobulinemia (WM) is a rare B-cell lymphoproliferative disorder.
- Characterized by bone marrow infiltration and IgM monoclonal paraproteinemia.
- Current treatments like alkylators and nucleoside analogs with rituximab often lead to relapse.
Purpose of the Study:
- To review recent advances in WM treatment.
- Focus on investigational drugs with promising activity.
- Highlight future prospects for WM therapy.
Main Methods:
- Review of clinical investigations and data on novel WM drugs.
- Discussion of drugs targeting proteasomes, PI3K/AKT/mTOR pathway, and surface antigens.
- Evaluation of bendamustine and immunomodulatory drugs in combination therapies.
Main Results:
- Bortezomib shows potential as a major treatment option.
- Everolimus, perifosine, and bendamustine (especially with rituximab) demonstrate activity.
- Targeting surface antigens and synergistic combinations with rituximab show promise.
Conclusions:
- Combination therapies with novel and established agents are feasible and improve response rates.
- Further investigation is needed to determine the impact on patient survival.
- Toxicity profiles are crucial for assessing the clinical feasibility of new WM drugs.
