For Older Patients with CLL, Ibrutinib May Be an Effective New Treatment Option

ASCO Annual Meeting
May 31, 2014

Early results from an ongoing study show that ibrutinib (Imbruvica) keeps relapsed chronic lymphocytic leukemia (CLL) from worsening for longer than ofatumumab (Arzerra), a standard treatment option for relapsed or refractory CLL. CLL is the most common type of leukemia in adults. Relapsed CLL is when the disease returns after remission, a time when there are no signs or symptoms of the disease. Refractory CLL is when the disease worsens despite treatment.

The standard treatment for CLL is a combination of chemotherapy and rituximab (Rituxan). However, many older patients, who are more likely to develop CLL, are not healthy enough for this intensive treatment regimen. For these patients, ofatumumab is often used as an alternative for relapsed or refractory disease. In this study, 40% of the participants were older than 70.

Ibrutinib, ofatumumab, and rituximab are all different types of targeted therapies. A targeted therapy is a treatment that targets the leukemia’s specific genes, proteins, or the tissue environment that contributes to the growth of the disease.

This study included 391 older patients with relapsed or refractory CLL or a subtype of CLL called small lymphocytic lymphoma that had worsened after they had already received two or more different treatments. For the study, they received either ofatumumab or ibrutinib. After about 9 months, 42% of patients who received ibrutinib had their disease improve, compared with 4% of those who received ofatumumab. Additionally, patients who received ibrutinib had an 80% lower risk of the disease worsening and a 57% lower risk of dying than patients who received ofatumumab. Because ibrutinib was so effective, patients receiving ofatumumab were offered treatment with ibrutinib instead. Overall, researchers found that ibrutinib causes few severe side effects.

What this means for patients

“With ibrutinib, about 80% of patients were still in remission at one year, twice as many as we would expect with standard therapy,” said lead study author John Byrd, MD, a professor of medicine at the Ohio State University Comprehensive Cancer Center in Columbus. Ibrutinib was approved by the U.S. Food and Drug Administration in February 2014 for patients with CLL who have received at least one previous treatment.

Questions to ask your doctor

  • What type of CLL do I have? Has it worsened or come back?
  • What are my treatment options?
  • How is my health in general? Will it affect the treatment options available to me?
  • What is my chance of recovery?

More Information

Guide to Chronic Lymphocytic Leukemia

Targeted Treatments

When the First Treatment Doesn't Work