The results of a multi-center phase III clinical trial showed that if elderly patients with chronic lymphocytic leukemia ( CLL ) are treated with a new targeted drug ibrutinib compared with the previously commonly effective regimen-bendamustine combined with rituximab The disease progression rate of mAb was significantly reduced, which also shows that rituximab combined with ibrutinib will not bring additional benefits over ibrutinib alone.
CLL is the most common leukocyte cancer in the elderly. In 2016 , the US FDA approved ibrutinib as the first-line treatment for CLL . Previous studies have shown that ibrutinib is more effective than another chemotherapeutic drug chlorambucil, but no studies have compared ibrutinib with bendamustine plus rituximab.
The trial enrolled 547 older patients with a median age of 71 years. 1/3 were randomly assigned to receive bendamustine Tingjia Li rituximab, 1/3 accepted by Lu rituximab for Nijia Li, 1/3 alone by Lu imatinib. The researchers followed up for a median of 38 months.
Compared with bendamustine plus rituximab ( 74 % at 2 years ), ibrutinib plus rituximab ( 88 % at 2 years ) and ibrutinib alone ( 2 At year, 87 %) patients had a longer progression-free survival rate (the primary endpoint of the study). However, the study found no difference in the overall survival rates of the three groups at 2 years.
Compared with receiving ibrutinib alone, adding rituximab to ibrutinib did not seem to improve the prognosis. Overall, patients responded well to all three treatment options. The overall response rate of patients receiving bendamustine plus rituximab was 81 %, and patients receiving ibrutinib plus rituximab to 93 % by Lu individual patients receiving imatinib therapy was 94 %.
Although the rate of complete eradication of leukemia using bendamustine plus rituximab was higher, this difference did not translate into better survival rates or lower relapse rates. So be more careful when choosing drugs.
However, ibrutinib is associated with significant side effects such as atrial fibrillation and abnormal heart rhythms that increase the risk of stroke and other cardiovascular diseases. The patient pays attention to monitoring the heart condition during use.
https://medicalxpress.com/news/2018-12-ibrutinib-outperforms-chemoimmunotherapy-older-patients.html
