Is ibrutinib alone, or combined with rituximab a more effective treatment for chronic lymphocytic leukemia?

This study examined if ibrutinib alone, or combined with rituximab is a more effective treatment for chronic lymphocytic leukemia (CLL). This study concluded that both treatments have similar survival, but adding rituximab to ibrutinib leads to faster remissions.

CLL is a cancer of the bone marrow. This leads to abnormal cells of the immune system. It is often treated with drugs that target the immune system. These include rituximab (Rituxan). Ibrutinib (Imbvruvica) is a targeted therapy. It works by blocking a protein that promotes cancer cell survival. This leads to cancer cell death.

It is not known if ibrutinib alone, or combined with rituximab is a more effective treatment for CLL. 
 

208 patients with CLL were included in this study. 181 patients had received previous treatment for CLL. 27 patients had untreated high-risk disease, due to abnormal genes. All patients took ibrutinib daily. Half of the patients also received six cycles of rituximab. Patients were followed up for an average of 36 months.

During this follow up, 86% of patients receiving ibrutinib were alive without cancer progression. This is compared to 86.9% of patients receiving ibrutinib plus rituximab. Complete remission is when no signs of cancer are seen on scans or blood tests. Complete remission was experienced by 20% of patients receiving ibrutinib, and 26% of patients receiving ibrutinib with rituximab. Patients treated with ibrutinib with rituximab reached remission faster.

Side effects were similar among both groups (64% ibrutinib vs. 65% ibrutinib and rituximab). The most common side effects were high blood pressure, infections, abnormal blood results, and irregular heart rhythms. 

This study concluded that adding rituximab to ibrutinib had similar outcomes as ibrutinib alone. However, patients who received the combined treatment reached remission faster.