Environmental or self-antigens and homotypic interactions trigger BCR and Toll-like receptor (TLR) signaling, amplifying the reaction of CLL cells to other signals within the microenvironment and expanding the activation of anti-apoptotic and proliferation pathways. Duvelisib was the 2nd PI3K inhibitor approved from the FDA, also according to a phase III https://scottw110rgx8.wikijm.com/user