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Alert Number 44

Exciting New Drugs on the CLL Horizon

Date: September 29, 2004

I am happy to report, the light at the end of the tunnel is getting brighter (and it is NOT an approaching train).

Several recent research articles have opened up exciting new opportunities in the treatment of CLL. These feature new small molecule drugs that take an entirely different approach to targeting CLL cells. These are not your father's chemotherapy drugs, most of which target the nuclear DNA of cells, with the unavoidable risk of mutagenicity. Nor are they bulky (and expensive!) monoclonal antibodies like Rituxan and Campath, which have a hard time dealing with bulky lymph nodes and bone marrow - to some degree because it is hard for these "fat ladies" to get into all the nooks and crannies of bone marrow and lymph nodes. Small molecules like the ones we discuss below are more likely to reach all these hard-to-reach parts.

Here is the best part: in this new approach to treating CLL: it seems to make no difference if you are IgVH mutated or unmutated, CD38 positive or not, chemo-na´ve or have been through the wars with every chemotherapy drug known to man. In fact, there are some indications that heavily pretreated and late Rai stage patients may respond better to this approach! How is that for a change? Rejoice all ye Bucket C folks!

You can read all about these developments in Target Mitochondrion. I sense a buzz in the research community - I would not be surprised if we start seeing some of these drugs in clinical trials as early as 2005.

Be well,


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