Spotlight on ibrutinib and its potential in frontline treatment of chronic lymphocytic leukemia

Figures & data

Table 1 Indications for treatment initiation according to the International Workshop on Chronic Lymphocytic Leukemia (IWCLL)⁶

1	Advanced clinical stage of the disease (Rai stage III or IV, Binet stage C)
2	A significant or progressive lymphadenopathy (longest dimension >10 cm) or splenomegaly (>6 cm below the costal margin)
3	Cytopenia due to disease progression or autoimmune disorders (lack of response to corticosteroids or other standard treatments)
4	General symptoms (weight loss, fever, fatigue, infection)
5	Lymphocyte doubling time of <6 months or an increase of >50% in <2 months (in patients with lymphocytosis <30 g/L, this doubling time should not be the only indication for treatment)
6	Richter transformation

Table 2 Studies with ibrutinib as frontline treatment for chronic lymphocytic leukemia

Study	No of patients	R/R	Treatment	Median age, range (years)	ORR%	PFS (months)	OS (months)
Burger et al^Citation29	40	Yes: 36 No: 4a	Ibrutinib + rituximab	63 (35–82)	95	18 (78%)	18 (83.8%)
O’Brien et al^Citation36	31	No	Ibrutinib (low dose vs high dose)	71 (65–84)	71	24 (96%)	24 (96%)
Byrd et al^Citation39	31b	No	Ibrutinib	71 (65–84)	84	20 (96%)	20 (97%)
Farooqui^Citation38	33b	No	Ibrutinib (untreated vs treated)	62 (33–82) vs 62 (56–79)	97	24 (91% vs 80%)	24 (84% vs 74%)
Burger et al^Citation31	269	No	Ibrutinib vs chlorambucil	73 (65–89) vs 72 (65–90)	86 vs 35	18 (90% vs 52%), P<0.001	24 (98% vs 85%), P=0.001

Notes:

a Four patients with untreated disease.

b Data only of those patients receiving initial therapy with ibrutinib are shown.

Abbreviations: ORR, overall response rate; OS, overall survival; PFS, progression-free survival; R/R, relapsed/refractory.

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