New research study reported in NEJM: Ibrutinib–Rituximab or Chemoimmunotherapy for Chronic Lymphocytic Leukemia

[jdolinger]

Found this to be a good news article. I know some will say study was funded heavily by drug companies, but so what....I base my opinion on the integrity of the researchers.

nejm.org/doi/full/10.1056/N...

This post by Dr Koffman provides very valuable context for this study - explaining why the Rituximab appears to be unnecessary - Admin

healthunlocked.com/cllsuppo...

[PlanetaryKim]

Great results and conclusion: "The ibrutinib–rituximab regimen resulted in progression-free survival and overall survival that were superior to those with a standard chemoimmunotherapy regimen [FCR] among patients 70 years of age or younger with previously untreated CLL."

But what I don't understand is that an earlier study comparing ibrutinib with or without rituximab to BR chemo found that ibrutinib with rituximab was no more effective than ibrutnib alone as monotherapy. (And both were superior to BR.) So why is anyone still trialing ibrutinib with rituximab, since that exposes patient to unnecessary toxicity, since ibrutinib as monotherapy delivers same overall survival and progression free survival?

[Benlewis in reply to PlanetaryKim]

I was wondering the same thing

[AussieNeil Administrator in reply to Benlewis]

I think that this would all be explainable by the amount of time it takes to collect and analyze the results. Also, valuable data can be gained by continuing the trial beyond 3 years. How would we know which trial gave longer remissions if we stopped one trial?

[Smakwater in reply to AussieNeil]

BeeBopAlooLa Neil.

The Broader your view, The more You see!

I love it when the complex issues are stated in simple terms.

Thank You

JM

[SethB34 in reply to PlanetaryKim]

Yep, I'm wondering the exact same thing. Who needs 2 drugs when only one is needed for efficacy? Perhaps the pharmaceutical company marketing rituximab is worried they won't be able to fund their Christmas ski vacation to the Alps if their drug is proven to be not essential.

[schmitthj007]

It is a landmark trial especially since it was positive for almost all subgroups. I would love to see how this trial develops over the years to come to see if the results remain the same. For one subgroup with low risk mutation and mutated, FCR seems similar and might still be an option for those patients.