Real-world ibrutinib dose reductions, holds and discontinuations in chronic lymphocytic leukemia

Area of Science:

• Oncology
• Hematology
• Pharmacology

Background:

• Chronic lymphocytic leukemia (CLL) is a common B-cell malignancy.
• Ibrutinib is a targeted therapy used for CLL treatment.
• Understanding treatment modifications in real-world settings is crucial.

Purpose of the Study:

• To evaluate the frequency and reasons for dose reductions, holds, and discontinuations of ibrutinib in CLL patients.
• To analyze these modifications in both first-line and relapsed/refractory patient populations.

Main Methods:

• Retrospective chart review of 180 adult CLL patients initiating ibrutinib.
• Patients were followed for at least 6 months.
• Data collected on dose modifications and reasons, primarily adverse events.

Main Results:

• 25% of first-line ibrutinib patients required dose reductions, mostly due to adverse events (79%).
• 20% discontinued and 34% had dose holds, primarily due to adverse events (73% and 74%).
• In relapsed/refractory patients, ~25% had dose reductions, 40% discontinued, and 40% had dose holds, with adverse events being the main cause (58-76%).

Conclusions:

• Dose reductions, holds, and discontinuations are frequent occurrences for ibrutinib in routine CLL care.
• Adverse events are the predominant driver for these treatment modifications.
• These findings highlight the need for careful monitoring and management of ibrutinib therapy in CLL patients.