What Are the Treatments for CLL?
There are a variety of approved treatments for CLL.1 Some work in different and unique ways, and they are sometimes used in combination with each other.2
There are many factors to consider when you and your doctor discuss which treatment option is best for you, such as3,4:
- Your overall health status
- Potential benefits and risks of treatment
- How different treatments work
- Genetic testing results
- How long treatments are taken
It's important to understand the different types of treatment options so you and your doctor can select the treatment that aligns best with your goals.
Commonly Used Treatment Approaches
Chemotherapy is used to stop the growth of fast-growing cells—such as cancer cells. Other cells, such as those in the hair and digestive tract, are also fast growing, which makes them sensitive to the effects of chemotherapy as well. In CLL, chemotherapy is commonly used in combination with immunotherapies and is also known as chemo-immunotherapy.5-7
Immunotherapy is a type of therapy that uses substances to stimulate or suppress the immune system.8
- Antibody Therapies: Antibodies are Y-shaped proteins of the immune system that help your body detect and mark cancer cells for destruction by your immune system3
- Immunomodulators: This type of treatment is used to modify some parts of the immune system to treat cancer or to maintain favorable results from the main treatment3
Targeted therapies specifically target proteins that are involved in the growth and survival of cancer cells.9
- BCL-2 Inhibitors: Apoptosis is the natural self-destruction of old or damaged cells, including cancer cells. This process may be disrupted when you have CLL. BCL-2 inhibitors target a specific protein in your body, to help restore the process of apoptosis and kill cancer cells3,10
- Kinase Inhibitors: Kinases are proteins found within cells, and some kinases support cancer cell growth. Kinase inhibitors are targeted therapies used to slow growth signals to lower the number of new cancer cells being made. Two kinds of kinase inhibitors for CLL are Bruton tyrosine kinase (BTK) inhibitors and phosphoinositide 3-kinase (PI3K) inhibitors3,10
Common Treatment Options for CLL
The chart below summarizes the treatment regimens commonly used for CLL.
Slide the scroll bar below to view the full chart.
Talk to your doctor to determine which approach fits best with your CLL treatment goals.
1. Leukemia & Lymphoma Society. The CLL guide: information for patients and caregivers. Revised 2014. Accessed November 30, 2020. https://www.lls.org/sites/default/files/file_assets/cllguide.pdf 2. National Cancer Institute. Drugs approved for leukemia. Updated November 25, 2019. Accessed July 2, 2020. https://cancer.gov/about-cancer/treatment/drugs/leukemia 3. National Comprehensive Cancer Network. NCCN Guidelines for Patients: chronic lymphocytic leukemia. Accessed November 3, 2019. https://www.nccn.org/patients/guidelines/content/PDF/cll-patient.pdf 4. Brander D, Islam P, Barrientos JC. Tailored treatment strategies for chronic lymphocytic leukemia in a rapidly changing era. Am Soc Clin Oncol Educ Book. 2019;39:487-498. 5. Jaglowski S, Jones JA. Choosing first-line therapy for chronic lymphocytic leukemia. Expert Rev Anticancer Ther. 2011;11(9):1379-1390. 6. Canadian Cancer Society. Chemotherapy for chronic lymphocytic leukemia. Updated November 25, 2019. Accessed July 30, 2020. https://www.cancer.ca/en/cancer-information/cancer-type/leukemia-chronic-lymphocytic-cll/treatment/chemotherapy/?region=on 7. American Cancer Society. Chemotherapy side effects. Updated May 1, 2020. Accessed July 30, 2020. https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/chemotherapy-side-effects.html 8. National Cancer Institute. Definition of immunotherapy. Accessed June 4, 2020. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/immunotherapy 9. National Cancer Institute. Definition of targeted therapy. Accessed July 2, 2020. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/targeted-therapy 10. American Cancer Society. Targeted therapy drugs for chronic lymphocytic leukemia. May 10, 2018. Updated November 25, 2019. Accessed July 9, 2020. https://www.cancer.org/cancer/chronic-lymphocytic-leukemia/treating/targeted-therapy.html 11. Fischer K, et al. Blood. 2016;127(2):208-215. doi:10.1182/blood-2015-06-651125. 12. Seymour JF, et al. N Engl J Med. 2018;378(12):1107-1120. doi:10.1056/NEJMoa1713976. 13. Goede V, et al. Leukemia. 2015;29(7):1602-1604. doi:10.1038/leu.2015.14. 14. Burger JA. N Engl J Med. 2015;373(25):2425-2437. doi:10.1056/NEJMoa1509388. 15. Sharman JP, et al. Lancet. 2020;395(10232):1278-1291. doi:10.1016/S0140-6736(20)30262-2. 16. Shanafelt TD, et al. N Engl J Med. 2019;381(5):432-443. doi:10.1056/NEJMoa1817073. 17. Shanafelt TD, et al. N Engl J Med. 2019;381(5)(suppl):432-443. doi:1056/NEJMoa1817073. 18. Moreno C, et al. Lancet Oncol. 2019;20(1):43-56. doi:10.1016/S1470-2045(18)30788-5. 19. Fischer K, et al. N Engl J Med. 2019;380(23):2225-2236. doi:10.1056/NEJMoa1815281. 20. Robak T, et al. J Clin Oncol. 2010;28(10):1756-1765. doi:10.1200/JCO.2009.26.4556. 21. Byrd JC, et al. N Engl J Med. 2014;371(3):213-223. doi:10.1056/NEJMoa1400376. 22. Ghia P, et al. J Clin Oncol. 2020;38(25):2849-2861. doi:10.1200/JCO.19.03355. 23. Flinn IW, et al. Blood. 2018;132(23):2446-2455. doi:10.1182/blood-2018-05-850461. 24. Furman RR, et al. N Engl J Med. 2014;370(11):997-1007. doi:10.1056/NEJMoa1315226.