Dr. Mato on Ibrutinib-Based Combinations in CLL

Anthony R. Mato, MD, MSCE, hematologic oncologist, director, CLL Program, Memorial Sloan Kettering Cancer Center, discusses ibrutinib (Imbruvica)-based combinations in chronic lymphocytic leukemia (CLL).

In the phase III Alliance A041202 trial, investigators demonstrated that the combination of ibrutinib and rituximab (Rituxan) was superior to bendamustine plus rituximab in terms of progression-free survival (PFS) for patients ≥65 years old with untreated CLL. However, they did not show improved PFS or overall survival (OS) with the ibrutinib-based combination compared with ibrutinib alone, explains Mato.

Similarly, in a randomized phase II trial (NCT02007044),investigators failed to show PFS benefit with ibrutinib plus rituximab versus ibrutinib alone in patients with relapsed CLL.

As such, ibrutinib monotherapy is the standard of care for frontline and relapsed/refractory CLL. Though, trials are investigating ibrutinib in combination with venetoclax (Venclexta), anti-CD20 agents, and PI3K inhibitors, concludes Mato.