Comparing chemoimmunotherapy and ibrutinib treatment in patients with chronic lymphocytic leukemia

This study aimed to compare the outcomes of patients with chronic lymphocytic leukemia who received chemoimmunotherapy or ibrutinib. This study suggested that ibrutinib may have more favorable outcomes for these patients when compared to chemoimmunotherapy.

Chemoimmunotherapy (CIT) is a treatment option that can be used for chronic lymphocytic leukemia (CLL). It combines chemotherapy and immunotherapy. The chemotherapy kills cancer cells while the immunotherapy helps to boost the immune system to fight cancer.

Ibrutinib (Imbruvica) is a tyrosine kinase inhibitor (TKI) and can also be used to treat CLL. This is a targeted therapy. Targeted therapies kill cancer cells without damaging normal, healthy cells. It was not established if one of these treatment methods had an advantage over the other for patients with CLL.  

This study compared 2 groups of patients from different clinical trials. One group involved patients from one trial who received ibrutinib as their initial treatment. The other group involved patients from other trials who received CIT as their initial treatment. The patients treated with CIT received various combinations of chemotherapy and immunotherapy. Progression-free survival (PFS; time patients were alive without disease progression), overall survival (OS; total time patients were alive) and safety for CIT and ibrutinib were compared. Patients were followed for an average of 3 years. The average age of patients was 61 to 74 years old.

The PFS after 3 years was longer for the ibrutinib group (83.8%) when compared to the CIT group (42.8%-59.1%). OS was similar in the two groups of patients. 

The frequency of side effects was similar between treatment with ibrutinib (73%) and CIT (70%). The most common included infections (9-40% with CIT and 25% with ibrutinib) and low white blood cell count (26-84% with CIT and 12% with ibrutinib).

This study suggested that ibrutinib may have more favorable outcomes for patients with CLL when compared to CIT.

This was a comparison between patients in several clinical trials with different protocols. Randomized, comparative studies are needed to support these findings.

Consult your physician about ibrutinib as a treatment option.