German CLL12: ibrutinib vs W&W - update at EHA 2019. (spoiler: they are still recommending W&W)

[avzuclav]

Source: twitter.com/lymphomahub/sta...

This was a late-breaking presentation today.

[ikahan]

From the graph, over the 54 month study period, 101 out of 180 subjects in the placebo group progressed to symptomatic CLL, whereas only 30 out of 180 in the ibrutinib group progressed. this was a large and highly significant difference. However, some subjects in the ibrutinib group had well-known complications, including a fib, hypertension and bleeding. so the authors are awaiting the results on mortality before concluding that watch and wait should be abandoned in favour of ibrutinib.

two year ago my husband received ibrutinib while still asymptomatic, as part of a small clinical trial headed by Dr Byrd. I am very glad he did as he remains asymptomatic with low counts.

[cajunjeff]

It looks to me like the data are not mature enough to know if ibrutinib has changed the watch and wait paradigm so the study doctors are playing it safe and saying for the time being watch and wait is still the standard.

I don’t know if it will ever be one size fits all, but I do think in time the data will show some groups or sub groups will benefit from early treatment. Some doctors are already believe that’s where it is headed and are treating earlier.

There is risk for some treating early and likely risk for some in waiting. Time will tell.

[Smakwater]

avzuclav,

I understand the medical industries need to substantiate new drugs, but, I'm putting my fingers in my ears with the everyone is watch and wait bait.

My view is that beyond FCR there is enough adequate data supporting greater benefit and lower toxicities with newer agents that consideration should be given in individual cases where quality of life concern is greater than or equal to both length of life and risk. Provided that risk is understood and accepted clearly by the patient.

I am not here for a long time, I'm here for a good time. Let's mess this place up!

youtube.com/watch?v=RZFfSpk...(Not working as expected?)

JM