Dr. Tedeschi on Frontline Ibrutinib for Older Patients With CLL

Alessandra Tedeschi MD, Department of Hematology, Azienda Ospedaliera Niguarda Ca' Granda in Milan, Italy, discusses the long-term findings of the phase III RESONATE-2 trial during the 2019 European Hematology Association Congress.

Ibrutinib, a once-daily BTK inhibitor, is approved for the frontline treatment of patients with chronic lymphocytic leukemia (CLL). The RESONATE-2 study, a phase III open-label trial, compared the efficacy and safety of the agent in the first-line setting versus chlorambucil in older patients, aged 65 years or older, with CLL.

The study demonstrated that ibrutinib, used as a single agent, had sustained benefit in terms of overall survival (OS) and progression-free survival (PFS), even for patients who had high-risk genomic features. Responses to the agent improved over time. With 66 months of follow-up, more than half of the 269 patients enrolled remain on treatment.

According to Tedeschi, treating older patients with CLL has always been a challenge, because many patients are unfit, and they may have comorbidities or intolerance to immunotherapy. Ibrutinib has provided a useful, more easily tolerated treatment option that has performed well in this patient population in terms of PFS and OS.

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