**6.5 Venetoclax (Venclexta)**

Is a selective drug that targets BCL-2, a protein in CLL cells had a manageable response for patients with small lymphocytic lymphoma (SLL) poor prognostic and chronic lymphocytic leukemia whose relapsed or refractory to other drugs (**Tables 4** and **5**) [52].


**127**

*Target Therapy in Hematological Malignancies DOI: http://dx.doi.org/10.5772/intechopen.84696*

Immune checkpoint inhibitors Ipilimumab

Small molecule inhibitors Ibrutinib

**7. Non-Hodgkin's lymphomas (NHL)**

deaths in 2018.

**Table 5.**

**7.1 Rituximab**

or without Rituximab.

CD20+ NHL and CLL [55].

**7.2 Radioimmunotherapy**

*7.2.1 Ibritumomab tiuxetan*

Non-Hodgkin's lymphoma is one of the most common hematologic neoplasms and there will be an estimated in USA over 79,000 new cases and over 20,000

*Novel antibodies directed against immune checkpoint proteins and novel small molecule inhibitors [49].*

**Mechanism Drug Target**

Pidilizumab Nivolumab Pembrolizumab

> Idelalisib Duvelisib Copanlisib Navitoclax Venetoclax

CTLA-4 PD-1 PD-1 PD-1

BTK PI3Kd PI3Kgd PI3Kd Bcl-2 Bcl-2

Diffuse large B cell lymphoma (CD20+) is the most common type followed by follicular lymphoma and the treatment choices for patients is CHOP protocol with

Rituximab is achimeric anti-CD20 human monoclonal IgG1 effective directly on the surface receptor found on typical pre-B and mature B cell of non-Hodgkin's lymphoma subtypes, driving to cell cytotoxicity and cell death [53]. It was at first utilized in aggressive and very aggressive relapsed or refractory lymphoma and

Major toxicities patients with NHL include infusion-related fever chills, fatigue, pruritus, nausea, and vomiting, angioedema, *headache, hypotension, bronchospasm*, urticaria during the first infusion. Rituximab was approved in November 1997 for medical use of refractory or relapsed lymphoma (B-cell). Rituximab play excellent role in combination with chemotherapy and represents a paradigm shift in treatment of lymphomas and improve the outcome for all

Radioimmunotherapy (RIT) is a safe and effective treatment option that combines the advantages of radiotherapy and immunotherapy and advance the adequacy of anti-CD20 target therapy by combining the antibody with a radiocon-

Is a monoclonal antibody of IgG1 kappa with name (Zevalin) and the first radiopharmaceuticals to be approved for patients with NHL of B lymphocytes CD20 molecules. Ibritumomab linking to the metal chelator tiuxetan, a monoclonal antibody (111In Zevalin™, Biogen Idec) stable binding of indium-111 (111In) for

radionucleotide tumor possible with 90Y ibritumomab tiuxetan [56].

demonstrated safety with disease regression and free survival [54].

jugate, yttrium-90 without risk of secondary malignancies.
