Expert Point of View: Martin Dreyling, MD and Joshua Brody, MD

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Martin Dreyling, MD, Professor at the University of Munich in Germany, said the most important lymphoma studies presented at the 2012 ASH Annual Meeting focused on ibrutinib, the first-in-class Bruton’s tyrosine kinase inhibitor.

“Basic science has gone mainstream. We will see a revolution during the next 5 years in the treatment of lymphoma [and other cancers] based on understanding of both genetic alterations and epigenetics,” he commented.

“The Bruton’s tyrosine kinase inhibitor ibrutinib is the molecule of the year,” he continued. “This drug is a major advance—one of the three major advances that I have seen over 25 years of treating hematologic cancers. The first was rituximab [Rituxan], the second was imatinib [Gleevec], and now we have ibrutinib.”

Phase II studies of ibrutinib presented at the ASH meeting focused on chronic lymphocytic leukemia (abstracts 187 and 189), mantle cell lymphoma (abstract 904), and diffuse large B-cell lymphoma (abstract 686). “These studies show impressive and unprecedented response rates with excellent tolerability,” Dr. Dreyling said. “We are all anxious to see the results of phase III trials and to have this drug available to treat our patients.”

Lymphoma session moderator Joshua Brody, MD, of Mount Sinai School of Medicine, New York, was equally impressed. “Ibrutinib is great in a few tumors—mantle cell and chronic lymphocytic leukemia—and it is very encouraging in others,” he said. “We are seeing fantastic data.” He added “While we still can’t cure relapsed/refractory mantle cell lymphoma, the good news is that we now have a lot of treatment choices, and some are quite good. The overall survival rate today is certainly not as dismal as the historical 3- to 5-year rate that is often quoted.” ■

Disclosure: Dr. Dreyling is on the scientific advisory board of Celgene, Janssen, Pfizer, and Roche; has received speakers honoraria from Celgene, Janseen, Mundipharma, Pfizer, and Roche; and receives support of academic studies (to the institution) from Celgene, Janssen, Mundipharma, Pfizer, and Roche. Dr. Brody reported no potential conflicts of interest. 

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