Simon Rule, MD, PhD, on Long-Term Outcomes with Ibrutinib Versus Prior Treatment Regimens

The expert hematologist from Plymouth University Medical Center discussed the long-term outcomes of patients receiving ibrutinib for mantle cell lymphoma at the ASH Annual Meeting and Exposition.

At the 61st American Society of Hematology (ASH) Annual Meeting and Exposition, held December 7-10, in Orlando, Florida, Simon Rule, MD, PhD talked about the findings from up to 7.5 years of extended follow up of patients receiving ibrutinib (Imbruvica) for relapsed/refractory mantle cell lymphoma (MCL).

So, what we did was just further follow up a group of patients that we've been looking at for a while now. So, it's 3 trials of patients receiving single agent ibrutinib. And basically, just long-term follow-up to see whether with a longer exposure to drug you're developing side effects or whether efficacy remains still there. So, it's basically additional safety analysis.

What we found was that a portion of the patients still remain on drug with 7.5-year follow up. There's no emergence of new toxicity, which is very encouraging. But perhaps the most important bit of the analysis was for the first time we looked at how response to ibrutinib compared with their prior therapies. With mantle cell lymphoma, when you use chemotherapy, each time you use a different chemotherapy, you get less of a response. This is a common thing we see with lymphomas. But with mantle cell lymphoma, when you use ibrutinib, what we find is the ibrutinib response is generally better than the prior chemotherapy.

And in 1 group, it's spectacularly better. And that's the patients that get the most benefit from the chemotherapy. So that's a group of people that would be more inclined to use chemotherapy again. But actually, that group gets the most benefit. In fact, the average benefit is more than a year from the second therapy compared with the first. So, this is against what we normally find with chemotherapy. So, it's just further encouraging use of these drugs earlier in the treatment paradigm.