All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit the Lymphoma Coalition.
Introducing
Now you can personalise
your Lymphoma Hub experience!
Bookmark content to read later
Select your specific areas of interest
View content recommended for you
Find out moreThe Lymphoma Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the Lymphoma Hub cannot guarantee the accuracy of translated content. The Lymphoma Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The Lymphoma & CLL Hub is an independent medical education platform, sponsored by Beigene and Roche, and supported through educational grants from Bristol Myers Squibb, Ipsen Biopharmaceuticals, Lilly, Pfizer, and Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC View funders.
Bookmark this article
On 14th May 2017, during iwCLL, the fifth session took place titled “Additional Considerations for the Initial Treatment of CLL.” This session was chaired by Richard Furman (Weill Cornell) and Jae Park (Memorial Sloan Kettering Cancer Center).
Nitin Jain, from the University of Texas MD Anderson Cancer Center, Houston, Texas, USA, gave a presentation titled “Ibrutinib, fludarabine, cyclophosphamide, and obinutuzumab (GA101) (iFCG) for previously untreated patients with Chronic Lymphocytic Leukemia (CLL) with mutated IGHV and non-del(17p)” during this session.
Results of this phase II trial (NCT02629809) were presented; the primary endpoint of the study was CR/CRi with negative MRD in bone marrow.
Response were measured as outlined by the iwCLL 2008 criteria:
|
3 months |
|
---|---|---|
|
N=24 (%) |
BM MRD (%) |
ORR |
24/24 (100) |
20/24 (83) neg |
CR/CRi |
10/24 (42) |
All neg |
PR |
14/24 (58) |
10/14 (71) neg |
After 3 cycles, a higher proportion of patients treated with iFCG were MRD negative (83%) compared to patients who received FCR (26%).
Moreover, a higher pre-treatment β2M correlated with a lower rate of MRD negativity after 3 cycles of iFCG (P = 0.035):
|
n |
BM MRD negativity (%) |
---|---|---|
β2M ≥4 |
6 |
50 |
β2M<4 |
18 |
94 |
*9 patients (31%) had grade 2 IRR |
||
|
N (%) |
|
---|---|---|
|
G3 |
G4 |
Neutropenia |
9 (31) |
12 (41) |
Thrombocytopenia |
12 (41) |
1 (3) |
ALT/AST |
3 (10) |
1(3) |
Atrial fibrillation |
1 (3) |
|
Arthralgia |
1 (3) |
|
IRR* |
1 (3) |
|
Reported infections included: neutropenic fever (n=4), as well as PCP pneumonia, pulmonary MAC infection, acute cholecystitis, and herpes zoster (n=1 each).
Dose reductions were reported in 57% of patients for FC and 18% of patients for ibrutinib. Treatment delay >2 weeks was reported in 35% of patients (due to thrombocytopenia, transaminitis, and infection).
Nitin Jain finished his talk with a concise conclusion slide:
Understanding your specialty helps us to deliver the most relevant and engaging content.
Please spare a moment to share yours.
Please select or type your specialty
Your opinion matters
Subscribe to get the best content related to lymphoma & CLL delivered to your inbox