Evolution of ibrutinib resistance in chronic lymphocytic leukemia (CLL)
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Significance: Chronic ymphocytic leukemia is the most common leukemia, mostly arising in patients over the age of 50. The disease has been treated with chemo-immunotherapies with varying outcomes, depending on the genetic make-up of the tumor cells. Recently, a promising new tyrosine kinase inhibitor, ibrutinib, has been developed, which resulted in successful responses in clinical trials, even for the most aggressive chronic lymphocytic leukemia types. The crucial current questions include how long disease control can be maintained in individual patients, when drug resistance is expected to arise, and what can be done to counter it. Computational evolutionary models, based on measured kinetic parameters of patients, allow us to address these questions and to pave the way toward a personalized prognosis.
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Modeling based on the error rate of DNA replication, overall disease burden, and proliferative history of CLL suggests that these mutations are acquired during the natural history of the disease rather than after BTKi initiation.
“However, modeling based on the error rate of DNA replication, overall disease burden, and proliferative history of CLL suggests that these mutations are acquired during the natural history of the disease rather than after BTKi initiation(32).”
From Resistance Mechanisms and Approach to Chronic Lymphocytic Leukemia after BTK Inhibitor Therapy (2025) · cites this paper as [32]
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BindingDB (2018) · UC San Diego · doi:10.7270/q29k4d6f
- Authors
- Komarova, N. L., Burger, J. A., & Wodarz, D.
- Affiliations
- University of California, Irvine (US)
- The University of Texas MD Anderson Cancer Center (US)
- Venue
- Proceedings of the National Academy of Sciences
- Publisher
- National Academy of Sciences
- Published
- 2014-09-08
- Volume
- 111
- Issue
- 38
- Pages
- 13906-13911
- ISSN
- 0027-8424 (ISSN-L)
- 1091-6490
- PMC
- PMC4183279
- OpenAlex
- W2046543570
- Cited by
- 98
- References
- 39
- Citations by year
- 2025: 2 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 10 · 2019: 15 · 2018: 11 · 2017: 12 · 2016: 15 · 2015: 9 · 2013: 1
- FWCI
- 6.02
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Proceedings of the National Academy of Sciences (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- Funders
- National Cancer Institute (P30CA016672)
- Topics
- Health Sciences › Medicine › Genetics › Chronic Lymphocytic Leukemia Research
- Physical Sciences › Mathematics › Modeling and Simulation › Mathematical Biology Tumor Growth
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Keywords
- ibrutinib, chronic lymphocytic leukemia, BTK inhibitors, drug resistance, resistance mutations, tumor evolution, kinetic model, clonal evolution, progression-free survival, chemoimmunotherapy, fitness advantage, individualized prognosis
- MeSH terms
- Agammaglobulinaemia Tyrosine Kinase, Adenine, Humans, Models, Biological, Mutation, Neoplasm Proteins, Piperidines, Prognosis, Protein-Tyrosine Kinases, Pyrazoles, Pyrimidines, Leukemia, Lymphocytic, Chronic, B-Cell, Drug Resistance, Neoplasm, Evolution, Molecular
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