jbm-202286-real-world-experience-of-ibrutinib-therapy-in-relapsed-chron.pdf (1.09 MB)
Real-world experience of Ibrutinib therapy in relapsed chronic lymphocytic leukaemia: results of a single-centre retrospective analysis
Version 2 2023-06-07, 08:23
Version 1 2023-06-07, 06:34
journal contribution
posted on 2023-06-07, 08:23 authored by Elisabeth Nuttall, Joanna Tung, Ellie Trounce, Rosalynd Johnston, Timothy ChevassutTimothy ChevassutBackground: Ibrutinib is a Bruton’s tyrosine-kinase (BTK) inhibitor that is approved as a second-line treatment in chronic lymphocytic leukemia (CLL). While recent trials have demonstrated impressive results for ibrutinib, there remains a paucity of real-world data on its use in the clinical setting. Methods: In this single-center study carried out at Brighton and Sussex University Hospitals, we retrospectively compared outcomes in 38 patients with relapsed CLL who received ibrutinib versus those who received conventional first- and second-line therapies. Results: Our results demonstrate improved progression-free survival (PFS, p=0.022) with ibrutinib versus conventional second-line therapies and survival comparable to conventional first-line therapies. However, there was a high frequency (81.6%) of adverse events associated with ibrutinib therapy, including 2 cases of death secondary to sepsis and a further 7 cases of discontinuation of treatment due to adverse events. We also identify del13q14.3 as an adverse predictor of response to ibrutinib with respect to both overall survival (p=0.014) and PFS (p=0.008), suggesting that these patients may be better suited to receiving the BCL2 inhibitor venetoclax. Conclusion: Whilst there is robust evidence for improved outcomes with ibrutinib, we find that survival in patients with del13q14.3 is reduced and that the rate of adverse events and discontinuation in clinical practice is higher than anticipated from clinical trials.
Funding
How does SARS CoV-2 infect blood vessels?; G3146; UK RESEARCH AND INNOVATION; MR/V036750/1
Modelling and targeting Acute Myeloid Leukaemia cells in the Bone Marrow protective niche; G3106; SUSSEX CANCER FUND FOR TREATMENT AND RESEARCH
In vitro modelling and therapeutic targeting of tumour cell migration in chronic lymphocytic leukaemia.; G2544; BLOODWISE; 18005
Drug-induced selective lethality in populations of DNMT3A knockdown cells; G2782; WELLCOME TRUST; 218435/Z/19/Z
Mining the Wnt signalling-responsive surfaceome for drug targets in acute myeloid leukaemia; G3090; WELLCOME TRUST
History
Publication status
- Published
File Version
- Published version
Journal
Journal of Blood MedicineISSN
1179-2736Publisher
Dove Medical PressExternal DOI
Volume
10Page range
199-208Department affiliated with
- BSMS Publications
Full text available
- No
Peer reviewed?
- Yes
Legacy Posted Date
2019-06-07First Open Access (FOA) Date
2019-07-15First Compliant Deposit (FCD) Date
2019-07-15Usage metrics
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