The Bottom Line:
Targeted therapies have greatly improved survival outcomes for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). For example, Ibrutinib is so effective at controlling CLL / SLL that the overall survival of patients treated with first-line ibrutinib is no different from that of the general population.
Who Performed the Research and Where Was it Presented:
Dr. Paolo Ghia from Università Vita-Salute San Raffaele in Milan, Italy, and colleagues presented the results at the American Society for Hematology Annual Meeting in 2022.
Since it was first approved in 2013, the Bruton tyrosine kinase (BTK) inhibitor ibrutinib has revolutionized the treatment of CLL and SLL. Targeted therapies have significantly improved patient outcomes and drastically reduced chemotherapy use. However, now that ibrutinib has been available for over ten years, researchers wanted to know if it changed the life expectancy of patients.
In this video, Dr. Alan Skarbnik, Director of the CLL program at Novant Health Cancer Institute in Charlotte, NC, interviewed Dr. Paolo Ghia, Director of the Strategic Research Program on CLL at Università Vita-Salute San Raffaele in Milan, Italy. They discussed new data on the overall survival of patients first treated with ibrutinib.
Methods and Participants:
Data were pooled from three phase 3 clinical trials, which evaluated ibrutinib alone and combined with other agents in patients with previously untreated CLL / SLL. In addition, Ibrutinib was compared with chemotherapy and the age-matched general population. For the age-matched analysis, data were restricted to patients who were ≥65 y at the time of initial CLL diagnosis. Their outcomes were compared with a simulated age-matched data cohort from the general population.
- Pooled data from the 603 ibrutinib-treated patients were compared to data from patients who received chemotherapy/chemoimmunotherapy.
- As expected, ibrutinib treatment significantly improved 3- and 5-year overall survival compared with chemotherapy/chemoimmunotherapy.
- The 5-year overall survival was 88% with ibrutinib vs. 75% with chemotherapy/chemoimmunotherapy.
- To compare ibrutinib data to an age-matched general population, 201 pts aged ≥65 y at initial diagnosis were pooled from the three clinical studies.
- The estimated overall survival rate at eight years was comparable between ibrutinib (78%) and the age-matched general population (77%).
- This suggests that ibrutinib can control CLL / SLL in such a way that the life expectancy of patients is no different than that of the general population.
This is an exciting finding because you would generally expect someone with CLL / SLL to have a shorter life expectancy just because of cancer. However, the data here clearly show that targeted therapies like ibrutinib are so effective in controlling CLL / SLL that the overall survival of patients is no different from that of the general population.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: Initiating First-Line (1L) Ibrutinib (Ibr) in Patients (pts) with Chronic Lymphocytic Leukemia (CLL) Improves Overall Survival (OS) Outcomes to Rates Approximating an Age-Matched Population of ≥65 Years
Take care of yourself first.
Ann Liu, PhD