New Leukemia Drug Shows Promising Results

Ibrutinib should become the new standard of care for treating elderly patients with chronic lymphocytic leukemia (CLL), said researchers.

Newer targeted drug ibrutinib was more effective than standard therapy for treating elderly patients with chronic lymphocytic leukemia (CLL), found landmark study co-authored by a Loyola Medicine oncologist.

The drug is taken as a pill once a day - much more convenient than the standard treatment requiring the patient to come in three times a month for infusions and an injection. "Ibrutinib should become the new standard of care," said Loyola oncologist Scott Smith, MD, PhD, one of the senior authors of the study, which was published in The New England Journal of Medicine.

Chronic Lymphocytic Leukemia
Chronic Lymphocytic Leukemia (CLL) is one of the most common types of adult leukemia and is considered as one of the ‘good cancers’.

‘The drug, ibrutinib, attacks cancer cells without damaging normal cells, thus causing fewer side effects.’

In 2016, the U.S. Food and Drug Administration approved ibrutinib (brand name, Imbruvica) for treatment of CLL.

Dr. Smith is a professor in the division of ematology/oncology, department of medicine of Loyola Medicine and Loyola University Chicago Stritch School of Medicine. He was executive officer of the Alliance for Clinical Trials in Oncology, which coordinated the study, and was responsible for the execution of the study.

CLL, a disease of the immune system, is the most common form of leukemia in adults. It affects mainly older adults, with the average age of diagnosis around 70. The risk is higher in men. Until now, the standard treatment has been a combination of a chemotherapy drug (bendamustine) that kills cancer cells and an immunotherapy drug (rituximab) that suppresses the immune system.

Ibrutinib
Ibrutinib belongs to a group of medications called as kinase inhibitors. It is prescribed for the treatment of cancer of the cells of the immune system (mantle cell lymphoma) in patients who have been treated earlier with a minimum of one chemotherapy medication. Ibrutinib is also used in the treatment of a cancer that begins in the white blood cells (chronic lymphocytic leukemia) and in the lymph nodes (small lymphocytic lymphoma), and a type of non-Hodgkin’s lymphoma (Waldenström macroglobulinemia). It mainly stops the spread of the cancer cells by blocking the abnormal proteins that signals them to multiply.

The study enrolled 547 CLL patients (67 percent male) at 219 centers in the United States and Canada. All were older than 65, with a median age of 71. Researchers randomly assigned patients to receive one of three regimens: the standard treatment of bendamustine plus rituximab;

ibrutinib alone; or ibrutinib plus rituximab. After two years, 87 percent of patients receiving ibrutinib alone were alive without any disease progression, compared with 74 percent of patients who received bendamustine plus rituximab. There was no significant difference between patients receiving ibrutinib alone and those receiving ibrutinib plus rituximab.