Dr. Jacobs on Treating Graft-Versus-Host-Disease With Ibrutinib in CLL

Ryan W. Jacobs, MD, physician, Levine Cancer Institute, discusses the use of ibrutinib (Imbruvica) in treating chronic graft-versus-host disease in patients with chronic lymphocytic leukemia (CLL).

At Levine Cancer Institute, rates of chronic GVHD are fairly low when physicians use posttransplant cyclophosphamide. For patients who ultimately develop chronic GVHD and become refractory to steroids, ibrutinib is the first and only FDA-approved agent available for this population, says Jacobs. On August 2, 2017, the FDA approved the BTK inhibitor for the treatment of adult patients with chronic GVHD following the failure of 1 or more lines of systemic therapy.

The single-arm, phase Ib/II PCYC-1129 trial that led to the agent’s approval was designed to ween successful patients off of ibrutinib; however, it's not an indefinite indication, adds Jacobs. Traditionally, these patients who have poor outcomes were without any FDA-approved options beyond steroids. With this approval, ibrutinib has filled an unmet need for patients with this condition, concludes Jacobs.