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Real-world experience of Ibrutinib therapy in relapsed chronic lymphocytic leukaemia: results of a single-centre retrospective analysis

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Version 2 2023-06-07, 08:23
Version 1 2023-06-07, 06:34
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posted on 2023-06-07, 08:23 authored by Elisabeth Nuttall, Joanna Tung, Ellie Trounce, Rosalynd Johnston, Timothy ChevassutTimothy Chevassut
Background: 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 Medicine

ISSN

1179-2736

Publisher

Dove Medical Press

Volume

10

Page range

199-208

Department affiliated with

  • BSMS Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2019-06-07

First Open Access (FOA) Date

2019-07-15

First Compliant Deposit (FCD) Date

2019-07-15

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