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Novel Approaches in Waldenström Macroglobulinemia
Michael A Spinner1, Gaurav Varma2, Ranjana H Advani1
1Division of Oncology, Department of Medicine, Stanford University, Stanford Cancer Institute, 875 Blake Wilbur Drive, Stanford, CA 94305, USA.
Abstract:
Recent advances in the understanding of Waldenström macroglobulinemia (WM) biology have paved the way for development of a plethora of novel therapeutic strategies. The success of ibrutinib in WM has shifted treatment paradigms away from conventional chemoimmunotherapy approaches. Recognition of high-risk genomic subgroups as well as mechanisms of acquired resistance to ibrutinib have led to targeting of additional pathways. In this article, the authors review ongoing and emerging trials of novel therapies in WM that target the B-cell receptor pathway beyond ibrutinib, toll-like receptor pathway, chemokine signaling, apoptotic pathway, chromatin remodeling, protein transport, the immune microenvironment, and CD19-directed immunotherapy.
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