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Published on: January 22, 2019
Emerging protein kinase inhibitors for the treatment of non-Hodgkin's lymphoma
Sudy Jahangiri1, Jonathan Friedberg, Paul Barr
1University of Rochester Medical Center , Rochester, NY , USA paul_barr@urmc.rochester.edu.
Introduction:
non-Hodgkin's lymphoma (NHL) accounts for 4.3% of all new cancers in the United States. Even in its most curable subtypes, approximately 30% of patients succumb to their disease. For these patients there is clear need for more effective therapy. In indolent NHL where survival is prolonged, the aim of therapy is improving quality of life and limiting the burden of therapy.
Areas Covered:
The key signaling mechanisms of normal B-cells, the changes that are seen in signaling in NHL, and the targets of novel protein kinase inhibitors (PKIs) are discussed. The efficacy of these agents in both aggressive and indolent histologies is reviewed. Logical combinations of novel and traditional agents are explored. Ongoing studies of the new agents are discussed.
Expert Opinion:
PKIs will likely modify standard therapeutic paradigms in NHL. As use of these agents increases and combination studies continue, optimal use will depend on individual disease characteristics, goals of therapy as well as patient and societal costs. Future clinical trials need to be designed with appropriate end points given prolonged use in many cases of these orally administered, well tolerated compounds. Further, safeguards against cumulative and/or unique side effects need to be in place given the novel signaling pathways being targeted.
Insights
Novel protein kinase inhibitors (PKIs) show promise for treating non-Hodgkin's lymphoma (NHL). Further research and clinical trials are needed to optimize their use and manage potential side effects.
Area of Science:
- Oncology
- Hematology
- Pharmacology
Background:
- Non-Hodgkin's lymphoma (NHL) represents 4.3% of US cancer diagnoses.
- A significant portion of NHL patients, even with curable subtypes, face disease progression.
- There is a critical need for improved therapeutic strategies in NHL, particularly for indolent forms focused on quality of life.
Purpose of the Study:
- To discuss signaling mechanisms in B-cells and their alterations in NHL.
- To review novel protein kinase inhibitors (PKIs) targeting these pathways.
- To explore the efficacy and combination strategies of PKIs in various NHL subtypes.
Main Methods:
- Review of B-cell signaling pathways in normal and malignant states.
- Analysis of preclinical and clinical data on novel protein kinase inhibitors (PKIs).
- Exploration of rational combinations of PKIs with existing therapies.
Main Results:
- PKIs target key signaling pathways dysregulated in NHL.
- These agents demonstrate efficacy across aggressive and indolent NHL histologies.
- Combination therapies involving PKIs are being investigated for enhanced outcomes.
Conclusions:
- Protein kinase inhibitors (PKIs) are poised to transform NHL treatment paradigms.
- Optimal PKI use will necessitate personalized approaches considering disease specifics, therapeutic goals, and costs.
- Future trials must accommodate prolonged treatment durations and monitor for unique toxicities associated with novel pathway targeting.
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