Dr. William Wierda on Role for Ibrutinib in Frontline CLL

William G. Wierda, MD, PhD, medical director of the Leukemia Center at The University of Texas MD Anderson Cancer Center, discuses which chronic lymphocytic leukemia (CLL) patients may benefit from ibrutinib frontline therapy and questions that remain after the RESONATE-2 trial.

The RESONATE-2 trial, investigated frontline therapy for patients over 65 receiving treatment with either chlorambucil or ibrutinib. That trial was positive and showed an improvement in progression-free survival (PFS) as well as overall survival for patients that received ibrutinib as their first therapy.

However, the trial left questions regarding if everyone should receive frontline ibrutinib therapy, or just some patients, says Wierda.

One group of patients that should for sure receive ibrutinib therapy are patients that have a 17p deletion. This very small percentage of patients, totally about 5 to 8%, should not get chemotherapy or chemoimmunotherapy because their disease does not respond to that, says Wierda.