Abstract | BACKGROUND: METHODS: Data from 320 patients who received ibrutinib on clinical studies between 2010 and 2015 at The University of Texas MD Anderson Cancer Center were retrospectively analyzed. RESULTS: Long-term outcomes among patients with CLL after they discontinued ibrutinib were analyzed. Ninety of 320 patients (28%) who were treated on ibrutinib-based regimens discontinued ibrutinib. Of these, 80 had relapsed/refractory disease, and 10 were treatment-naive. The median time to discontinuation was 15 months (range, 1.2-54 months). After a median follow-up of 38 months after starting ibrutinib, 40 patients (44%) remained alive. Major reasons for ibrutinib discontinuation were intolerance (n = 29; 32%), miscellaneous (n = 28; 31%), progression (n = 19; 21%), and Richter transformation (RT) (n = 9; 10%). The median survival according to the reason for discontinuation was 33 months for ibrutinib intolerance, 11 months for miscellaneous causes, 16 months for progressive CLL, and 2 months for RT. Among the 19 patients who had progressive CLL, 42% responded to subsequent therapy. CONCLUSIONS:
Ibrutinib discontinuation was observed during therapy. Patients with CLL who had disease transformation had especially poor outcomes, whereas those who developed progressive disease during ibrutinib therapy had a median survival of <1.5 years. Survival was associated with the reason for discontinuation; patients who had progressive CLL had better survival compared with those who had disease transformation. Effective salvage strategies for patients with CLL who progress on ibrutinib therapy is of critical importance. Cancer 2017;123:2268-2273. © 2017 American Cancer Society.
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Authors | Preetesh Jain, Philip A Thompson, Michael Keating, Zeev Estrov, Alessandra Ferrajoli, Nitin Jain, Hagop Kantarjian, Jan A Burger, Susan O'Brien, William G Wierda |
Journal | Cancer
(Cancer)
Vol. 123
Issue 12
Pg. 2268-2273
(Jun 15 2017)
ISSN: 1097-0142 [Electronic] United States |
PMID | 28171709
(Publication Type: Journal Article)
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Copyright | © 2017 American Cancer Society. |
Chemical References |
- Piperidines
- Protein Kinase Inhibitors
- Pyrazoles
- Pyrimidines
- ibrutinib
- Adenine
|
Topics |
- Adenine
(analogs & derivatives)
- Adult
- Aged
- Aged, 80 and over
- Deprescriptions
- Disease Progression
- Drug-Related Side Effects and Adverse Reactions
- Female
- Follow-Up Studies
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell
(drug therapy)
- Male
- Middle Aged
- Piperidines
- Protein Kinase Inhibitors
(therapeutic use)
- Pyrazoles
(therapeutic use)
- Pyrimidines
(therapeutic use)
- Retrospective Studies
- Survival Rate
|