23 January 2019

Ibrutinib is more effective than standard therapy for treating elderly patients with chronic lymphocytic leukaemia (CLL), according to new research.

The study, published in the New England Journal of Medicine in December, compared single-agent ibrutinib with a combination of ibrutinib and rituximab, and the standard of care bendamustine and rituximab.

The study, led by Jennifer Woyach at Ohio State University, enrolled 547 CLL patients – 67% of whom were men – at 219 centres in the USA and Canada. All were 65 and over.

After two years, median disease-free survival was reached only with bendamustine and rituximab combination.  87% of patients receiving ibrutinib alone – and 88% receiving ibrutinib with rituximab – were alive without any disease progression, compared with 74% of patients who received bendamustine plus rituximab.

After a follow-up period of 38 months, there were no significant differences in overall survival between the three arms of the study, though the researchers say that it is still too early for any differences to become apparent.

Dr Scott Smith, of Loyola University Chicago Stritch School of Medicine, USA, and one of the senior authors of study, said “ibrutinib should become the new standard of care”.

Further studies are now being undertaken to assess ibrutinib in CLL patients under the age of 65.

Source: Woyach, J.A., Ruppert, A.S., Heerema, N.A., Zhao, W., Booth, A.M., Ding, W., Bartlett, N.L., Brander, D.M., Barr, P.M., Rogers, K.A., Parikh, S.A., Coutre, S., Hurria, A., Brown, J.R., Lozanski, G., Blachly, J.S., Ozer, H.G., Major-Elechi, B., Fruth, B., Nattam, S., Larson, R.A., Erba, H., Litzow, M., Owen, C., Kuzma, C., Abramson, J.S., Little, R.F., Smith, S.E., Stone, R.M., Mandrekar, S.J., Byrd, J.C. “Ibrutinib Regimens versus Chemoimmunotherapy in Older Patients with Untreated CLL”, New England Journal of Medicine, available at doi: 10.1056/NEJMoa1812836


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