Could Ibrutinib Combined With Other Targeted Therapies and Chemo Be ‘the Future’ of B-Cell Lymphoma Treatment?

Researchers Investigate Ibrutinib as Frontline Therapy

• Ibrutinib is a Bruton’s tyrosine kinase (BTK) inhibitor used to treat relapsed/refractory B-cell lymphoma
• Researchers are investigating whether combining ibrutinib with other novel agents might work as a frontline treatment
• Ibrutinib is generally well tolerated, but it can cause side effects such as bleeding and arrhythmias

New research is enhancing our understanding of ibrutinib — a Bruton’s tyrosine kinase (BTK) inhibitor used to treat several different types of lymphoma, including chronic lymphocytic leukemia (CLL), small lymphocytic leukemia (SLL), and mantle cell lymphoma. It has also produced positive responses in B-cell lymphoma, but is so far only used in patients with relapsed/refractory disease.

“Most often if you’re going to receive ibrutinib, it’s going to be when lymphoma has returned,” Dr. Sairah Ahmed, associate professor in the MD Anderson Cancer Center Division of Cancer Medicine, tells SurvivorNet Connect. Researchers are currently looking at whether combining this drug with chemotherapy might make an effective frontline therapy, too.

Dr. Ahmed’s colleague at MD Anderson, Dr. Jason Westin, has tested the combination of three targeted therapies — ibrutinib, lenalidomide, and rituximab — in the frontline setting, followed by chemotherapy. “After two cycles of this chemoimmunotherapy, they have excellent overall response rates,” Dr. Ahmed says.

Ibrutinib is generally well-tolerated, although it can cause side effects such as bleeding and arrhythmias. “It needs to be monitored closely and patients need to have blood work and see their oncologist once a month,” Dr. Ahmed says.

Researchers continue to investigate the best ways to combine these novel medications with chemotherapy, but Dr. Ahmed predicts that the combination of novel agents like ibrutinib and chemotherapy is “what we’re going to see in the future.”