Better Results for Chronic Lymphocytic Leukemia With Ibrutinib

On FRIDAY, June 21, 2024, researchers announced that first-line ibrutinib is linked to superior outcomes compared to chemoimmunotherapy in patients with chronic lymphocytic leukemia (CLL). This finding, published online on May 13 in the journal Clinical Lymphoma, Myeloma & Leukemia, comes from a study led by Dr. Nilanjan Ghosh of the Levine Cancer Institute in Charlotte, North Carolina.

The study was observational and used registry data from 1,459 patients diagnosed with CLL. These patients were enrolled in the study between October 2015 and June 2019. Among them, 854 patients received first-line therapy, while 605 individuals were treated in the relapsed/refractory setting.

The researchers focused on common initial treatments, with ibrutinib and chemoimmunotherapy being the primary options. They discovered that the median time to the next treatment (TTNT) was not reached in the first-line treatment group but was 48.6 months in the relapsed/refractory group. The median follow-up periods were 31.8 months for the first-line cohort and 30.9 months for the relapsed/refractory cohort. At the 48-month mark, 64 percent of patients in the first-line group and 50 percent in the relapsed/refractory group had not needed a subsequent treatment.

Overall survival (OS) rates were also analyzed. In both cohorts, median overall survival was not reached. The estimated 48-month OS rates were 81 percent for the first-line group and 64 percent for the relapsed/refractory group. When comparing ibrutinib to chemoimmunotherapy in a match-adjusted analysis, patients receiving first-line ibrutinib had a median TTNT that was not reached, compared to 56.5 months for those receiving chemoimmunotherapy. The hazard ratio was 0.74, indicating a 26 percent reduction in the risk of progressing to the next treatment with ibrutinib.

Furthermore, ibrutinib showed a better safety profile with lower rates of adverse events leading to treatment discontinuation and fewer serious adverse events compared to chemoimmunotherapy. The study also found that Black and White patients who received any initial treatment, including ibrutinib, had similar estimated 36-month overall survival rates.

The study authors highlighted that their findings suggest access to newer treatments like ibrutinib could help bridge historical gaps in clinical outcomes between Black and White patients with CLL.

It is important to note that several authors of the study disclosed relationships with pharmaceutical companies, including AbbVie, which funded the study. AbbVie’s subsidiary, Pharmacyclics, is the manufacturer of ibrutinib.