Ibrutinib Dose Reduction - An ASH Abstract

[gardening-girl]

In yesterday's discussion about the effect of ibrutinib on hair-texture, the topic of ibrutinib dose reduction was mentioned ( healthunlocked.com/cllsuppo... ). There is an ASH abstract reporting very encouraging results from a pilot study assessing ibrutinib dose reduction:

Abstract 4307 A Pilot Study of Lower Doses of Ibrutinib in Patients (pts) with Chronic Lymphocytic Leukemia

CLL

Conclusions: Taken together, these data suggest that IBR doses as low as 140 mg/d are sufficient to fully occupy BTK and abrogate kinase function. As off-target effects of IBR are not thought to contribute to clinical efficacy in CLL, exploration of lower doses is warranted to reduce the incidence of troublesome side effects such as AF and bleeding, while preserving efficacy. Accordingly, a larger, more definitive trial with clinical endpoints of IBR at a dose of 140 mg/d following 2 cycles at 420 and 280 mg/d is planned.

ash.confex.com/ash/2017/web...

[PlanetaryKim]

Great news! Thanks for sharing.

[starsafta]

I've been waiting to hear results of this study. So glad to see it. With lowered platelets and increased bleeding issues, I'm really hoping dose reduction can become standard. When I asked at my appointment at Dana Farber a few weeks ago, I was told they are not deviating from full strength at this time. I will offer myself as a guinea pig should they decide to run their own study. My numbers look great except for platelets. Seems worth trying, at least to me.

Thanks, Chris, for all your trolling and sharing.

[Indolent]

Yes, this will be a topic worthy of further study. The one-size-fits-all dosing seems counter intuitive. Yet even the experts in this field are still adhering to the "gospel" of the 420 mg dosing.