Dr. Woyach on Ibrutinib Regimens in Frontline CLL

Jennifer Woyach, MD, associate professor, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center—James, discusses the findings of the ALLIANCE AO41202 and ECOG-ACRIN E1912 trials in the frontline treatment for patients with chronic lymphocytic leukemia (CLL).

Both of these trials compared ibrutinib (Imbruvica) alone or in combination with another agent with standard chemotherapy as frontline treatment in patients with CLL, explains Woyach. The ECOG-ACRIN E1912 trial compared ibrutinib plus rituximab (Rituxan) with fludarabine, cyclophosphamide, and rituximab (FCR), for example. That study showed a significant advantage in both progression-free survival and overall survival with ibrutinib/rituximab versus FCR, according to updates presented at the 2019 ASH Annual Meeting.

Meanwhile, there is not much difference between regimens in the very good genomic-risk patients, including those with IGHV-mutated disease, says Woyach. The 2 treatments are fairly similar at this follow-up, though mostly because those patients do very well; no one has relapsed on either arm, concludes Woyach.