Dr. Jennifer Brown on Ibrutinib and Idelalisib for CLL

Jennifer Brown, MD, PhD, Director, Chronic Lymphocytic Leukemia Center, Dana-Farber Cancer Institute, Assistant Professor of Medicine, Harvard Medical School, discusses the treatment of chronic lymphocytic leukemia with ibrutinib, idelalisib, and other agents.

Ibrutinib is a covalent Bruton's tyrosine kinase inhibitor that has demonstrated a 70% response rate, according to Brown. In treatment-naïve patients, ibrutinib showed 90% progression-free survival over two years and 75% over two years in relapsed patients.

Idelalisib is an inhibitor of the delta isofrom of PI3K and showed a high response rate in relapsed refractory CLL. Idelalisib also demonstrated a PFS of 16 months in a phase I study. Brown notes that no large phase II study has begun yet and that other BTK and PI3K inhibitors are behind in development.

Dasatinib and everolimus have shown efficacy in other diseases but have not produced great results in CLL as single agents.

Syk inhibitors, such as fostamatinib, are also in development for CLL, Brown says.