The American Society of Hematology (ASH) annual meeting is the largest meeting of hematologists in the world. In 2016, it was held in San Diego and I had a chance to interview Dr. George Follows from the UK concerning his real world research on the experience of 300+ patients on ibrutinib and his take on the new updated long-term data.
We first discussed the important difference between clinical trial experience and real-world experience.
Dr. Follows shares some of his finding from his research published October 2016 in the open access journal Hematolologica. You can read his findings here: http://www.haematologica.org/content/early/2016/10/17/haematol.2016.147900
Take Away Points:
- Patients who took the full dose of the drug in the “real world” and didn’t miss more than 14 days of medication had an overall survival (OS) rate of 89.7% at one year. The OS was 83.8% for all comers.
- This strongly positive result is quite similar to that seen in clinical trials, but it is not always the case in oncology. Often clinical trial data are often much better than “real world data.
- Dose reduction did not affect OS, but missing more than 2 weeks of ibrutinib or stopping it completely resulted in the OS dropping to 68.5%.
- The 5 year data on ibrutinib presented at ASH 2016 by Susan O’Brien was similarly encouraging, especially for those who already had failed one or two lines of therapy. See below.
- Venetoclax is a good option for those patients whose CLL grows through ibrutinib.
The link to Dr. O’Brien’s long-term ibrutinib research presented at ASH 2016 is: https://ash.confex.com/ash/2016/webprogram/Paper89757.html where you will see this quoted from the results of the abstract:
Patients estimated to be alive at 60 m were: TN (treatment naïve), 92%; all R/R (relapsed/refractory), 57%; R/R del17p, 32%; R/R del 11q, 61%; R/R unmutated IGVH, 55%.
The interview with Dr. Follows is below.
Between Dr. Follows’ research and Dr. O’Brien’s abstract and other research, there is much to feel positive about.
Brian Koffman, MD 1/24/17