Dr. Roback on Subsequent Treatment Following Ibrutinib Discontinuation in CLL

Tadeusz Robak, MD, PhD, professor of hematology, Medical University of Lodz, chief, Department of Hematology, Copernicus Memorial Hospital, Lodz, Poland, discusses subsequent treatment after discontinuation of ibrutinib (Imbruvica) on the phase 3 RESONATE-2 trial (NCT01722487) in patients with chronic lymphocytic leukemia (CLL).

Of the patients enrolled on RESONATE-2, which examined ibrutinib vs chlorambucil in patients aged 65 years and older with CLL or small lymphocytic leukemia, 19 discontinued ibrutinib and were given subsequent therapy, according to Roback. Various chemoimmunotherapy regimens, such as fludarabine plus cyclophosphamide and rituximab (Rituxan), bendamustine plus rituximab, or chlorambucil and rituximab, were given to 9 patients. Additionally, 2 patients received subsequent treatment with only chemotherapy, and 7 patients were given novel agents, including venetoclax (Venclexta) alone or in combination with rituximab, Roback explains.

Notably, very few patients on the trial received subsequent treatment after ibrutinib discontinuation; immediate treatment is not necessary until disease progression, Roback adds. Notably, patients with CLL still experienced good remissions without progression and did not require further treatment, despite discontinuing treatment with ibrutinib, Roback concludes.