Utilizing Different Mechanisms of Action for Treatment of Chronic Graft-Versus-Host Disease - Episode 9
Ibrutinib in Chronic GVHD
Drs Yi-Bin Chen, Corey Cutler, Hannah Choe, and Mitchell Horwitz discuss the approval and real-world experiences of ibrutinib and ruxolitinib for chronic GVHD. The panel discusses the challenges and varying effectiveness observed in real-world usage, contrasting the experiences of the two drugs.
This is a video synopsis of a discussion involving Dr Yi-Bin Chen, Director of the Transplant and Cell Therapy Program at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School; Dr Corey Cutler, Director of the Stem Cell Transplant Program at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School; Dr Mitchell Horwitz, Professor of Medicine and Director of the Adult Blood and Marrow Transplant Program at Duke University, and Dr Hannah Choe, Assistant Professor and Director of the Graft-versus-Host-Disease (GVHD) program at Ohio State University.
The panelists focus on the approval and real-world experiences of two drugs, ruxolitinib and ibrutinib, for treating chronic GVHD.
Dr Mitchell Horwitz starts by discussing the approval of ibrutinib in the chronic GVHD setting. He reviews the data behind the approval, emphasizing the striking response rates observed in a single-armed phase 2 study. The best overall response rate was 67%, and the responses were durable, lasting 6 months to a year. However, Dr Horwitz notes that ibrutinib's real-world use presented challenges, with some patients experiencing infections, mucositis, and cardiac arrhythmias.
Dr Corey Cutler adds to the discussion by sharing the real-world experience with ibrutinib at his center. They found that it was not as effective as initially reported in the trial, and patients tended to discontinue it due to both lack of response and toxicity issues. Dr Cutler suggests that ibrutinib might not be as well-tolerated and effective outside the clinical trial population.
The panelists contrast this with the success of ruxolitinib, the first agent approved for chronic GVHD. Dr Hannah Choe discusses the Reach 3 trial, highlighting its positive outcomes and significant improvement in overall response rate compared to the best available therapy. Dr Yi-Bin Chen emphasizes the shift in clinical practices, with ruxolitinib becoming the first-line and second-line agent of choice for chronic GVHD.
In summary, the discussion provides insights into the challenges and real-world experiences associated with ibrutinib in treating chronic GVHD.
Video synopsis is AI-generated and reviewed by OncLive® editorial staff.
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