EFFICACY OF IBRUTINIB-BASED THERAPY IN THE TREATMENT OF RECURRENT AND REFRACTORY FORMS OF CHRONIC LYMPHOCYTIC LEUKEMIA
(Abstract release date: 05/19/16)
EHA Library. Kuvshinov A. 06/09/16; 134699; PB1799
Dr. Aleksei Kuvshinov
Contributions
Contributions
Abstract
Abstract: PB1799
Type: Publication Only
Background
Several studies in chronic lymphocytic leukemia (CLL) have determined the achievement of minimal residual disease (MRD) negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Novel therapies that incorporate purine analogs, monoclonal antibodies and new agents targeting the B-cell receptor signalling pathway recently improved response rates in relapsed/refractory CLL. The number of patients achieved MRD negative remission increased
Aims
To estimate of response rate and MRD after ibrutinib therapy in the treatment patients with relapsed/refractory CLL
Methods
47 pts were included in the analysis. Stratification of patients into prognostic groups based on identified chromosomal abnormalities by standard GTG-method and interphase FISH analyses with use of DNA probes: LSI RB1 (13q14), LSI ATM (11q22), CEP12, LSI TP53 (17p13.1) (Abbott). Group 1 (n = 26): 1st line rituximab-based chemotherapy (RB – 12, FCR – 14); Group 2 (n = 17): 2nd and subsequent lines of rituximab-based chemotherapy (RB – 12, FCR – 4, R-CHOP – 1) and Group 3 (n = 9): ibrutinib-based therapy (420 mg daily oral Ibrutinib ± Rituximab). Median age in Group 1 was 57 years (35-67), in Group 2 – 62 years (49-83), in Group 3 – 65 years (51-82). Patients received, regardless of the programs of therapy. We have used NCI-IWCLL revised guidelines for treatment initiation and assessment of response. MRD was detected by multicolor flow cytometry of bone marrow in patients achieved a complete or partial remission: Group 1 – 26 pts, Group 2 – 7 pts, Group 3 – 4 pts
Results
Patients with unfavorable chromosomal abnormalities were detected in each group: Group 1 – 4 pts (del(11q) – 3, complex karyotype – 1); Group 2 – 2 pts (combination del(11q) with del(13q)); Group 3 – 1 pts (del(17p)).Overall response rate (ORR) in Group 1 was 100%: complete remission (CR) ‒ 10 pts (unfavorable prognosis (UP) – 2), partial remission (PR) – 16 pts. Group 2: ORR 82% (CR – 1 pts, PR – 13 pts (UP – 2)); stable disease (SD) – 1 pts, progression disease – 2 pts. Group 3: ORR 89% (CR – 3 pts, PR – 5 pts (UP – 1); SD – 1 pts). MRD-negative remission was achieved in 46% pts in Group 1 (12/26: CR – 6 pts (UP – 1), PR – 6 pts (UP – 2)), in Group 2 – 14% (1/7, CR), in Group 3 – 25% (1/4, CR)
Conclusion
Evaluation of response and MRD after ibrutinib-containing programs therapy in the treatment patients with relapsed/refractory chronic lymphocytic leukemia require further research. The influence of genetic abnormalities on the treatment efficacy and MRD status has yet to be defined
Session topic: E-poster
Keyword(s): Chromosomal abnormality, Chronic lymphocytic leukemia, Minimal residual disease (MRD), Targeted therapy
Type: Publication Only
Background
Several studies in chronic lymphocytic leukemia (CLL) have determined the achievement of minimal residual disease (MRD) negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Novel therapies that incorporate purine analogs, monoclonal antibodies and new agents targeting the B-cell receptor signalling pathway recently improved response rates in relapsed/refractory CLL. The number of patients achieved MRD negative remission increased
Aims
To estimate of response rate and MRD after ibrutinib therapy in the treatment patients with relapsed/refractory CLL
Methods
47 pts were included in the analysis. Stratification of patients into prognostic groups based on identified chromosomal abnormalities by standard GTG-method and interphase FISH analyses with use of DNA probes: LSI RB1 (13q14), LSI ATM (11q22), CEP12, LSI TP53 (17p13.1) (Abbott). Group 1 (n = 26): 1st line rituximab-based chemotherapy (RB – 12, FCR – 14); Group 2 (n = 17): 2nd and subsequent lines of rituximab-based chemotherapy (RB – 12, FCR – 4, R-CHOP – 1) and Group 3 (n = 9): ibrutinib-based therapy (420 mg daily oral Ibrutinib ± Rituximab). Median age in Group 1 was 57 years (35-67), in Group 2 – 62 years (49-83), in Group 3 – 65 years (51-82). Patients received, regardless of the programs of therapy. We have used NCI-IWCLL revised guidelines for treatment initiation and assessment of response. MRD was detected by multicolor flow cytometry of bone marrow in patients achieved a complete or partial remission: Group 1 – 26 pts, Group 2 – 7 pts, Group 3 – 4 pts
Results
Patients with unfavorable chromosomal abnormalities were detected in each group: Group 1 – 4 pts (del(11q) – 3, complex karyotype – 1); Group 2 – 2 pts (combination del(11q) with del(13q)); Group 3 – 1 pts (del(17p)).Overall response rate (ORR) in Group 1 was 100%: complete remission (CR) ‒ 10 pts (unfavorable prognosis (UP) – 2), partial remission (PR) – 16 pts. Group 2: ORR 82% (CR – 1 pts, PR – 13 pts (UP – 2)); stable disease (SD) – 1 pts, progression disease – 2 pts. Group 3: ORR 89% (CR – 3 pts, PR – 5 pts (UP – 1); SD – 1 pts). MRD-negative remission was achieved in 46% pts in Group 1 (12/26: CR – 6 pts (UP – 1), PR – 6 pts (UP – 2)), in Group 2 – 14% (1/7, CR), in Group 3 – 25% (1/4, CR)
Conclusion
Evaluation of response and MRD after ibrutinib-containing programs therapy in the treatment patients with relapsed/refractory chronic lymphocytic leukemia require further research. The influence of genetic abnormalities on the treatment efficacy and MRD status has yet to be defined
Session topic: E-poster
Keyword(s): Chromosomal abnormality, Chronic lymphocytic leukemia, Minimal residual disease (MRD), Targeted therapy
Abstract: PB1799
Type: Publication Only
Background
Several studies in chronic lymphocytic leukemia (CLL) have determined the achievement of minimal residual disease (MRD) negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Novel therapies that incorporate purine analogs, monoclonal antibodies and new agents targeting the B-cell receptor signalling pathway recently improved response rates in relapsed/refractory CLL. The number of patients achieved MRD negative remission increased
Aims
To estimate of response rate and MRD after ibrutinib therapy in the treatment patients with relapsed/refractory CLL
Methods
47 pts were included in the analysis. Stratification of patients into prognostic groups based on identified chromosomal abnormalities by standard GTG-method and interphase FISH analyses with use of DNA probes: LSI RB1 (13q14), LSI ATM (11q22), CEP12, LSI TP53 (17p13.1) (Abbott). Group 1 (n = 26): 1st line rituximab-based chemotherapy (RB – 12, FCR – 14); Group 2 (n = 17): 2nd and subsequent lines of rituximab-based chemotherapy (RB – 12, FCR – 4, R-CHOP – 1) and Group 3 (n = 9): ibrutinib-based therapy (420 mg daily oral Ibrutinib ± Rituximab). Median age in Group 1 was 57 years (35-67), in Group 2 – 62 years (49-83), in Group 3 – 65 years (51-82). Patients received, regardless of the programs of therapy. We have used NCI-IWCLL revised guidelines for treatment initiation and assessment of response. MRD was detected by multicolor flow cytometry of bone marrow in patients achieved a complete or partial remission: Group 1 – 26 pts, Group 2 – 7 pts, Group 3 – 4 pts
Results
Patients with unfavorable chromosomal abnormalities were detected in each group: Group 1 – 4 pts (del(11q) – 3, complex karyotype – 1); Group 2 – 2 pts (combination del(11q) with del(13q)); Group 3 – 1 pts (del(17p)).Overall response rate (ORR) in Group 1 was 100%: complete remission (CR) ‒ 10 pts (unfavorable prognosis (UP) – 2), partial remission (PR) – 16 pts. Group 2: ORR 82% (CR – 1 pts, PR – 13 pts (UP – 2)); stable disease (SD) – 1 pts, progression disease – 2 pts. Group 3: ORR 89% (CR – 3 pts, PR – 5 pts (UP – 1); SD – 1 pts). MRD-negative remission was achieved in 46% pts in Group 1 (12/26: CR – 6 pts (UP – 1), PR – 6 pts (UP – 2)), in Group 2 – 14% (1/7, CR), in Group 3 – 25% (1/4, CR)
Conclusion
Evaluation of response and MRD after ibrutinib-containing programs therapy in the treatment patients with relapsed/refractory chronic lymphocytic leukemia require further research. The influence of genetic abnormalities on the treatment efficacy and MRD status has yet to be defined
Session topic: E-poster
Keyword(s): Chromosomal abnormality, Chronic lymphocytic leukemia, Minimal residual disease (MRD), Targeted therapy
Type: Publication Only
Background
Several studies in chronic lymphocytic leukemia (CLL) have determined the achievement of minimal residual disease (MRD) negativity as an independent favorable prognostic factor, leading to prolonged disease-free and overall survival, regardless of the treatment protocol or the presence of other pre-existing prognostic indicators. Novel therapies that incorporate purine analogs, monoclonal antibodies and new agents targeting the B-cell receptor signalling pathway recently improved response rates in relapsed/refractory CLL. The number of patients achieved MRD negative remission increased
Aims
To estimate of response rate and MRD after ibrutinib therapy in the treatment patients with relapsed/refractory CLL
Methods
47 pts were included in the analysis. Stratification of patients into prognostic groups based on identified chromosomal abnormalities by standard GTG-method and interphase FISH analyses with use of DNA probes: LSI RB1 (13q14), LSI ATM (11q22), CEP12, LSI TP53 (17p13.1) (Abbott). Group 1 (n = 26): 1st line rituximab-based chemotherapy (RB – 12, FCR – 14); Group 2 (n = 17): 2nd and subsequent lines of rituximab-based chemotherapy (RB – 12, FCR – 4, R-CHOP – 1) and Group 3 (n = 9): ibrutinib-based therapy (420 mg daily oral Ibrutinib ± Rituximab). Median age in Group 1 was 57 years (35-67), in Group 2 – 62 years (49-83), in Group 3 – 65 years (51-82). Patients received, regardless of the programs of therapy. We have used NCI-IWCLL revised guidelines for treatment initiation and assessment of response. MRD was detected by multicolor flow cytometry of bone marrow in patients achieved a complete or partial remission: Group 1 – 26 pts, Group 2 – 7 pts, Group 3 – 4 pts
Results
Patients with unfavorable chromosomal abnormalities were detected in each group: Group 1 – 4 pts (del(11q) – 3, complex karyotype – 1); Group 2 – 2 pts (combination del(11q) with del(13q)); Group 3 – 1 pts (del(17p)).Overall response rate (ORR) in Group 1 was 100%: complete remission (CR) ‒ 10 pts (unfavorable prognosis (UP) – 2), partial remission (PR) – 16 pts. Group 2: ORR 82% (CR – 1 pts, PR – 13 pts (UP – 2)); stable disease (SD) – 1 pts, progression disease – 2 pts. Group 3: ORR 89% (CR – 3 pts, PR – 5 pts (UP – 1); SD – 1 pts). MRD-negative remission was achieved in 46% pts in Group 1 (12/26: CR – 6 pts (UP – 1), PR – 6 pts (UP – 2)), in Group 2 – 14% (1/7, CR), in Group 3 – 25% (1/4, CR)
Conclusion
Evaluation of response and MRD after ibrutinib-containing programs therapy in the treatment patients with relapsed/refractory chronic lymphocytic leukemia require further research. The influence of genetic abnormalities on the treatment efficacy and MRD status has yet to be defined
Session topic: E-poster
Keyword(s): Chromosomal abnormality, Chronic lymphocytic leukemia, Minimal residual disease (MRD), Targeted therapy
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