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Giving the pill ibrutinib to people with early, symptom-free chronic lymphocytic leukaemia delayed the disease but, after almost six years, did not help them live longer than placebo, so doctors should keep watching and waiting rather than treating early.
Final analysis of the German CLL Study Group's randomised, double-blind, placebo-controlled phase 3 CLL12 trial: 363 patients with asymptomatic, treatment-naive Binet stage A chronic lymphocytic leukaemia at increased risk of progression received ibrutinib 420 mg daily (n 182) or placebo (n 181); 152 low-risk patients were followed on watch and wait.
Ibrutinib significantly delayed progression to symptomatic disease, but at a median observation of 69.3 months five-year survival was 93.3 percent with ibrutinib, 93.6 percent with placebo and 97.9 percent on watch and wait. Adverse events occurred in almost every patient in both groups, with more cardiovascular toxicity on ibrutinib.
Watch and wait remains the standard of care for early-stage chronic lymphocytic leukaemia irrespective of risk factors, even with a targeted drug available.
Shares CLL12, Chronic lymphocytic leukaemia, first treatment, Chronic lymphocytic leukaemia.
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Shares Chronic lymphocytic leukaemia, first treatment, Ibrutinib, Chronic lymphocytic leukaemia.
Shares Chronic lymphocytic leukaemia, first treatment, Ibrutinib, Chronic lymphocytic leukaemia.
Shares Chronic lymphocytic leukaemia, first treatment, Ibrutinib, Chronic lymphocytic leukaemia.
Shares Chronic lymphocytic leukaemia, first treatment, Chronic lymphocytic leukaemia.
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Shares Chronic lymphocytic leukaemia, first treatment, Ibrutinib, Chronic lymphocytic leukaemia.