Dr. Kahl on Ibrutinib in CLL

Brad Kahl, MD, professor in the Department of Medicine, Washington University School of Medicine, Siteman Cancer Center, discusses the use of ibrutinib (Imbruvica) in the treatment of patients with chronic lymphocytic leukemia (CLL).

In 2016, ibrutinib was FDA approved for the frontline treatment of CLL. Now, any patient can receive that therapy, which gives physicians more options to consider. Ibrutinib is very active in CLL and has demonstrated high response rates in addition to durable remissions, says Kahl. However, the BTK inhibitor is administered as a chronic daily therapy, whereas other therapies have a finite duration of administration, notes Kahl.

Patients who receive the fludarabine-cyclophosphamide-rituximab regimen or bendamustine plus rituximab (Rituxan) can anticipate coming off therapy, whereas patients on ibrutinib have to continue therapy indefinitely. Physicians do not yet have the comparative data to say that one is better than the other, adds Kahl. Therefore, deciding whether to pursue ibrutinib or an alternative regimen is something that should be discussed on an individualized basis.