Ibrutinib as an antitumor immunomodulator in patients with refractory chronic lymphocytic leukemia

Ibrutinib as Initial Therapy for Patients with Chronic Lymphocytic Leukemia.

BACKGROUND Chronic lymphocytic leukemia (CLL) primarily affects older persons who often have coexisting conditions in addition to disease-related immunosuppression and myelosuppression. We conducted an international, open-label, randomized phase 3 trial to compare two oral agents, ibrutinib and chlorambucil, in previously untreated older patients with CLL or small lymphocytic lymphoma. METHOD...

Outcomes of patients with chronic lymphocytic leukemia after discontinuing ibrutinib.

Ibrutinib is a Bruton tyrosine kinase inhibitor approved for the treatment of patients with relapsed refractory chronic lymphocytic leukemia (RR-CLL). We describe the characteristics, causes of discontinuation, and outcomes in patients who discontinued treatment with ibrutinib. One hundred twenty-seven patients were enrolled in various clinical trials of ibrutinib, with or without rituximab, at...

Beyond Ibrutinib Resistance in Chronic Lymphocytic Leukemia

Despite ibrutinib activity in multiple B-cell malignancies, cases of primary and secondary resistance have emerged. The overall reported frequency of resistance is low. Resistance has been found to be caused by a mutation in the BTK binding site of ibrutinib or gain-of-function mutations in PLCG2, which lead to autonomous BCR activity. Improved understanding of mechanisms of primary and seconda...

Ibrutinib resistance in chronic lymphocytic leukemia.

n engl j med 370;24 nejm.org june 12, 2014 2352 portant questions both about the nature of the evidence and about its sufficiency, a topic that has been the subject of inquiry and discussion in the patient-safety community for well over a decade.1 As noted in the editorial, replications have confirmed substantial effects regarding the use of a surgical checklist, but rigorous randomized trials ...

Ibrutinib, a novel agent in relapsed or refractory chronic lymphocytic leukemia.