New findings by Yale Cancer Center and Smilow Cancer Hospital researchers show that, as the use of ibrutinib increases in patients with chronic lymphocytic leukemia (CLL), so do the rates of patients who stop taking the drug. The study was presented at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition in Orlando, Florida.1
The oral Bruton’s tyrosine kinase inhibitor ibrutinib is a targeted treatment for CLL, approved by the U.S. Food & Drug Administration for both relapsed and newly diagnosed disease. Pivotal clinical trials found that ibrutinib shows favorable efficacy and is well tolerated in newly diagnosed patients, with about 9% discontinuing use after a year.
The researchers conducted a retrospective cohort study of patients with CLL treated at community clinics using the nationwide Flatiron Health database. They found that the use of ibrutinib in the first-line treatment of the disease climbed to about 40% of patients by late 2018. Among about 1,500 of these individuals who received adequate follow-up, about 16% stopped taking ibrutinib within 180 days of initiation. This early discontinuation rate was especially common among people 80 years or older and among those whose disease had already progressed enough that they could not perform any work.
The researchers noted that optimal strategies to manage ibrutinib-related toxicities are not well defined. They suggested that clinical decision support tools and other modern cancer care delivery approaches should be explored to improve the administration of novel CLL therapies.
DISCLOSURE: For full disclosures of the study authors, visit ash.confex.com.
1. Huntington SF, Soulos PR, Barr PM, et al: Utilization and early discontinuation of first-line ibrutinib for patients with chronic lymphocytic leukemia treated in the community oncology setting in the United States. 2019 ASH Annual Meeting & Exposition. Abstract 797. Presented December 9, 2019.