Ibrutinib Approved for Pediatric Patients With Chronic Graft-Versus-Host Disease

The FDA has approved ibrutinib (Imbruvica®, Pharmacyclics LLC) for treatment of pediatric patients with chronic graft-versus-host disease (cGVHD) following failure of one or more lines of systemic therapy. "Pediatric cGVHD, a potentially debilitating, life-threatening complication of allogeneic hematopoietic stem cell transplantation, has limited treatment options," wrote Marco Zecca, MD, Director of the Pediatric Oncology/Hematology Unit at the Fondazione IRCCS Policlinico San Matteo in Italy, ...

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Knowledge Gaps Revealed in Waldenström Macroglobulinemia

Waldenström macroglobulinemia is a rare lymphoproliferative disorder, with an estimated 1,500 new cases reported in the United States each year. This malignancy, which accounts for 2% of non-Hodgkin lymphomas, is characterized by lymphoplasmacytic bone marrow infiltration and the presence of serum monoclonal immunoglobulin M (IgM). It is important for health care professionals involved in the care of patients with Waldenström macroglobulinemia to remain up to date in their knowledge of risk stra...

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Ibrutinib/Rituximab FDA Approved: Treatment-Naive CLL/SLL

Today, the FDA expanded the approval of ibrutinib (Imbruvica®, Pharmacyclics LLC) to include combination therapy with rituximab for the first-line treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL). Ibrutinib, an oral Bruton's tyrosine kinase (BTK) inhibitor, has previously been approved for treatment-naive CLL in combination with obinutuzumab. The new approval was based on the Eastern Cooperative Oncology Group (ECOG) E1912 trial (NCT02048813), a mul...

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Ibrutinib Plus R-CHOP for Non-Germinal Center DLBCL With Wyndham Wilson, MD

Diffuse large B-cell lymphoma (DLBCL), the most common subtype of non-Hodgkin lymphoma, has a 5-year survival rate of 63%. However, patients with non-germinal center B-cell-like (non-GCB) disease and high MYC and BCL2 expression face a poorer prognosis, with limited treatment options. In the phase 3 PHOENIX trial, Wyndham Wilson, MD, the Head of the Lymphoma Therapeutics Section at the National Cancer Institute, and colleagues investigated a combination of ibrutinib and rituximab, cyclophosphami...

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Managing Ibrutinib-Related Hypertension in B-Cell Malignancies: Daniel Addison, MD

​Ibrutinib is an effective treatment for several B-cell malignancies, including mantle cell lymphoma, chronic lymphocytic leukemia, and Waldenstrom macroglobulinemia. However, it can cause cardiotoxicity. Under the direction of Daniel Addison, MD, a team of researchers recently found that hypertension caused or worsened by treatment with ibrutinib results in a greater than two-fold increased risk of major adverse cardiovascular events. In this interview with i3 Health, Dr. Addison discusses what...

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Ibrutinib/Venetoclax Promising in Relapsed/Refractory CLL

​CLARITY, a phase 2 clinical trial, reports that the combination of ibrutinib plus venetoclax in relapsed/refractory chronic lymphocytic leukemia (CLL) produces minimal residual disease (MRD)-negative responses, with promising rates of progression-free and overall survival. While some patients with CLL have indolent disease, for which treatment is not needed, others experience an aggressive progression of their cancer. For these patients, chemoimmunotherapy treatments such as fludarabine/cycloph...

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Ibrutinib/Rituximab Shows Promise in Chronic Lymphocytic Leukemia

Researchers conducted a phase 3 trial to determine if ibrutinib/rituximab compared with standard chemoimmunotherapy (fludarabine/cyclophosphamide/rituximab) is more effective at treating patients with treatment-naive chronic lymphocytic leukemia (CLL) and found that ibrutinib/rituximab increased progression-free survival and overall survival compared with standard chemoimmunotherapy. One of the most common lymphoid cancers in adults, CLL starts in white blood cells called lymphocytes in the bone...

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Ibrutinib Plus Venetoclax in Relapsed/Refractory CLL: Peter Hillmen, MBChB, PhD

​For patients experiencing aggressive chronic lymphocytic leukemia (CLL), chemoimmunotherapy often leads to remission, but remission is frequently followed by disease relapse. A new treatment option may soon emerge for these patients: the CLARITY study, a phase 2 clinical trial, has found that the combination of ibrutinib plus venetoclax produces minimal residual disease (MRD)-negative responses in individuals with relapsed and/or refractory CLL, with promising rates of progression-free and over...

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Ibrutinib Increases Hypertension and Cardiovascular Risk

For patients with B-cell malignancies, the hypertension caused or worsened by treatment with ibrutinib results in a two-fold increased risk of major adverse cardiovascular events, report researchers at The Ohio State University. Ibrutinib can be highly effective against B-cell malignancies such as mantle cell lymphoma, chronic lymphocytic leukemia, and Waldenstrom macroglobulinemia. However, it also is associated with cardiotoxicity. Severe hypertension has been reported, but "the long-term inci...

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