Authored by Ann Liu, PhD
Medically Reviewed by Brian Koffman, MDCM (retired), MSEd
The Bottom Line:
MRD-guided treatment with ibrutinib plus venetoclax significantly improved the quality of life for patients with relapsed / refractory CLL. Patients experienced reductions in fatigue, disease-related symptoms, and future health concerns.
Who Performed the Research and Where Was it Presented:
Dr. Laura Eurelings from Albert Schweitzer Hospital and colleagues presented the results at the American Society for Hematology (ASH) Annual Meeting 2024.
Background:
Chronic lymphocytic leukemia (CLL) / small lymphocytic lymphoma (SLL) is often diagnosed in older adults. While treatment efficacy is essential to patients, quality of life is another primary concern. Single therapies such as venetoclax and ibrutinib have been shown to improve the quality of life for patients with CLL / SLL. Researchers sought to investigate whether combination therapies, specifically ibrutinib plus venetoclax, also improve quality of life.
Methods and Participants:
This analysis was part of a phase 2 clinical trial of measurable residual disease (MRD)-guided time-limited ibrutinib-venetoclax in patients with relapsed / refractory CLL. Patients were treated with ibrutinib and venetoclax for 15 cycles. At the end of 15 cycles, if patients had detectable MRD, they continued on ibrutinib alone. If they had undetectable MRD, they were randomized to either ibrutinib maintenance or stopping treatment. Two questionnaires were used to assess quality of life. One was a general cancer questionnaire, and the other was CLL-specific. Questionnaires were administered at baseline, immediately after completing ibrutinib-venetoclax treatment, and 6 months, 1 year, 2 years, and 3 years after completing ibrutinib-venetoclax treatment.
Results:
- The analysis included 224 patients who completed at least one questionnaire.
- After 15 cycles of ibrutinib-venetoclax, 44% of patients experienced an improvement in their global health status, 41% maintained a stable health status, and 15% experienced a decline in health status.
- Six months after treatment, patients experienced a significant improvement in their global health status, decreased fatigue, fewer disease-related symptoms, and reduced future health worries compared to baseline.
- These changes persisted for 3 years after treatment.
- Clinically relevant improvements in quality of life were observed in both patients who discontinued treatment and those who continued on ibrutinib.
Conclusions:
While we already knew that MRD-guided ibrutinib-venetoclax is a highly effective combination for treating CLL / SLL, this study demonstrates that it can also enhance the quality of life for patients with relapsed or refractory CLL. MRD-guided treatment with ibrutinib-venetoclax significantly improved the quality of life for patients through improvements in overall health status and reductions in fatigue, disease-related symptoms, and future health concerns.
Links and Resources:
Watch the interview on the abstract here:
You can read the actual ASH abstract here: Quality of Life in Patients with Relapsed/Refractory Chronic Lymphocytic Leukemia Improves after Minimal Residual Disease-Guided Treatment with Ibrutinib Plus Venetoclax.
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