HORSHAM, PA – Veterans with chronic lymphocytic lymphoma who received ibrutinib as their first line treatment had a longer time to next treatment, according to recently-published research.

Authors of the industry study, which was conducted in a real-world veteran population, pointed out that evidence has been limited about the results of ibrutinib use in treatment-naïve veterans with CLL and/or small lymphocytic lymphoma (SLL).

Background information in the article, published in a supplement to Clinical Lymphoma, Myeloma & Leukemia, noted that CLL is the most common adult leukemia.1

Researchers sought to evaluate time to next treatment (TTNT) among U.S. veterans with CLL/SLL, who initiated first-line ibrutinib vs. first-line chemoimmunotherapy (CIT). They also evaluated first-line ibrutinib vs. ibrutinib in second-line/third-line usage.

Participants were adults with CLL/SLL who received first-line single agent ibrutinib or CIT, as documented in the VHA data base from April 1, 2013, to March 31, 2018. The study required continuous enrollment for 12 months pre- and 30 days post-index, and 787 CLL/SLL patients with first-line ibrutinib and 1,039 with first-line CIT — 597 with bendamustine plus rituximab—initially were identified..

At the same time, a subset of the first-line CIT cohort with ibrutinib use in second-line or third-line was defined as the 2L+ ibrutinib cohort. For purposes of the study, TTNT was defined as the time from treatment initiation of the regimen of interest until the start of next-line of therapy.

Researchers advised that the first-line ibrutinib cohort included more elderly patients than the first-line CIT cohort — mean 74.1 vs. 69.0 years — with both cohorts having a majority of men, (99.0%) and Caucasian (80.0%) patients.

The first-line CIT cohort had 409 patients with next-line of therapy; ibrutinib was the second-line or later in 185 (45.2%).

After propensity score matching, 614 patients were included in each of the first-line ibrutinib and first-line CIT cohorts, and 149 in each of the first-line ibrutinib and second-line plus ibrutinib cohorts.

Results indicated that the first-line Ibrutinib cohort had significantly longer TTNT as compared to the other alternatives and was less likely to require a next-line of treatment, compared to first-line CIT or second-line plus ibrutinib groups.

“These findings demonstrate that the use of first-line ibrutinib in CLL/SLL patients was associated with significantly longer TTNT, compared to first-line CIT or use of ibrutinib in later lines of therapy,” the authors concluded.

1.    Hang, Quing, Ellis L, Wang L, Shrestha S, Sundaram M. First-line Ibrutinib Treatment is Associated with Longer Time to Next Treatment in a Real-World US Veterans Population. Clinical Lymphoma, Myeloma and Leukemia, Volume 19, S285