Figure 3.
Figure 3. Future treatment concept with novel agents. For this treatment approach, I propose the term “sequential triple-T” (tailored, targeted, total eradication of MRD) to illustrate that this future approach should be a sequence of tailored measures (according to the risk of the leukemia, the tumor burden, and the fitness of the patients), should use targeted agents (ie, using the novel nonchemotherapeutic agents with a mechanism of action targeting pathogenic signaling events of CLL cells and their microenvironment), and aim at the total eradication of the leukemic clone (as assessed by MRD negativity as a clinical end point). Please note that the drugs or classes of drugs in this figure are shown as examples. Similar agents of the same class or additional classes of drugs (see Table 1) may be used as well.

Future treatment concept with novel agents. For this treatment approach, I propose the term “sequential triple-T” (tailored, targeted, total eradication of MRD) to illustrate that this future approach should be a sequence of tailored measures (according to the risk of the leukemia, the tumor burden, and the fitness of the patients), should use targeted agents (ie, using the novel nonchemotherapeutic agents with a mechanism of action targeting pathogenic signaling events of CLL cells and their microenvironment), and aim at the total eradication of the leukemic clone (as assessed by MRD negativity as a clinical end point). Please note that the drugs or classes of drugs in this figure are shown as examples. Similar agents of the same class or additional classes of drugs (see Table 1) may be used as well.

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