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ASH 2018: Dr. John Byrd, Ibrutinib and “A Second Chance at Life”

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By Larry Marion

Dr. John Byrd, the Ohio State University professor and principal investigator of the anti-CLL drug ibrutinib during its clinical trials, presented a 7-year follow up on the results of the clinical trial at the 2018 annual meeting of the American Society of Hematology in San Diego in early December. In a conversation at the ASH meeting with Dr. Brian Koffman, chief medical officer and EVP of the CLL Society (and one of Dr. Byrd’s patients in the clinical trial), Dr. Byrd offers commentary and context about his ASH presentation and related chronic lymphocytic leukemia research:

Key Take Aways

  • More than 80% of the previously untreated 32 CLL patients in the phase I clinical trial of ibrutinib “are still doing well.”
  • Almost all of the ibrutinib clinical trial patients who had been previously heavily pretreated, are “still with us. They wouldn’t be with us if they hadn’t gone on the trial. It is gratifying to see those patients get a second chance at life.”
  • A few percent of patients using ibrutinib have sudden cardiac deaths. Typically, these patients had heart issues before starting ibrutinib. In addition, atrial fibrillation has been noted in a small but significant percentage of patients using ibrutinib.
  • For new CLL patients presenting for treatment who are refractory and also have heart disease history, “I would often think of second-generation therapies like acalabrutinib or venetoclax with rituximab” for them. “I believe they would be better, though that’s not 100% clear.”
  • “We’re in a really neat place—for most patients just beginning their CLL treatment journey, they’re going to live with their disease for as long” as if they didn’t have the disease.

Author commentary:

As a CLL patient with deletion 11q and other negative prognostic factors, it is especially gratifying to see that ibrutinib shows success as a long-term treatment (ibrutinib is mostly agnostic to bad prognostic factors). Definitely encouraging to see that my obituary may say I died with CLL, not from CLL.

Here is the interview:

Here is a link to Dr. Byrd’s abstract from the ASH meeting:

http://www.bloodjournal.org/content/132/Suppl_1/3133

More information about Dr. Byrd’s research and his views on acalabrutinib:

https://cllsociety.org/2019/02/ash-2018-dr-john-byrd-on-acalabrutinib-in-cll/

Thanks for reading

Larry Marion

Larry Marion is a CLL survivor who has been using ibrutinib for more than five years, as well as a patient of Dr. Byrd. Marion is a former writer and editor for various business and technology magazines.

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