Start Over

Richter's transformation: Transforming the clinical landscape.

Authors :: Barrett A
Appleby N
Dreau H
Fox CP
Munir T
Eyre TA
Source :: Blood reviews [Blood Rev] 2024 Mar; Vol. 64, pp. 101163. Date of Electronic Publication: 2023 Dec 10.
Publication Year :: 2024
Abstract: Richter transformation (RT) represents an aggressive histological transformation from chronic lymphocytic leukaemia, most often to a large B cell lymphoma. It is characterised by chemo-resistance and subsequent short survival. Drug development has struggled over recent years in light of the aggressive kinetics of the disease, lack of pivotal registrational trials and relative rarity of the phenomenon. In this review we will highlight the diagnostic and therapeutic challenges of managing patients with RT as well as taking a look to the future therapeutic landscape. Highly active therapies developed across B cell malignancies are starting to impact this field, with T-cell activation therapies (CAR-T, bispecific antibodies), antibody-drug conjugates, and novel small molecule inhibitor combinations (e.g. BTKi-BCL2i) being actively studied. We will highlight the data supporting these developments and look to the studies to come to provide hope for patients suffering from this devastating disease.<br />Competing Interests: Declaration of Competing Interest AB has received travel expenses from Ionis Pharmaceuticals. NA has received speakers fees from Janssen and worked on trials funded by Janssen and AstraZeneca. CPF: Kite/Gilead/ Roche: Consultancy/ Advisory Boards, Educational Activities, Travel. AbbVie/ Incyte/ Janssen/ Takeda: Consultancy/ Advisory Boards, Educational Activities. AstraZeneca/ Atarabio/ BNS/ GenMab/ Lilly/ Morphosys/ Ono/ SERB/ SOBI: Consultancy/ Advisory Boards. BeiGene: Research Funding. TAE: Roche: Education Honorarium, Advisory Board Honorarium, Travel to scientific conferences. Gilead: Honorarium; Research support; Travel to scientific conferences. KITE: Education Honorarium, Advisory Board Honorarium, Janssen: Honorarium. Abbvie: Honorarium; Travel to scientific conferences. AstraZeneca: Honorarium, Research funding, Travel to scientific conferences. Loxo Oncology: Advisory Board Honorarium, Trial steering committee. Beigene: Advisory Board Honorarium, Research funding. Incyte: Advisory Board Honorarium. Secura Bio: Advisory Board Honorarium. HD and TM have no relevant conflicts of interest to declare.<br /> (Copyright © 2023. Published by Elsevier Ltd.)