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Long-term safety of single-agent ibrutinib in patients with chronic lymphocytic leukemia in 3 pivotal studies
Open accessAbstract
Ibrutinib, a first-in-class once-daily oral Bruton tyrosine kinase inhibitor indicated for chronic lymphocytic leukemia (CLL), is continued until progressive disease or unacceptable toxicity. We conducted an integrated safety analysis of single-agent ibrutinib from randomized phase 3 studies PCYC-1112 (RESONATE, n = 195) and PCYC-1115/1116 (RESONATE-2, n = 135), and examined longer-term safety separately in the phase 1b/2 PCYC-1102/1103 study (n = 94, 420 mg/d). In the integrated analysis (ibrutinib treatment up to 43 months), the most common adverse events (AEs) were primarily grade 1/2; diarrhea (n = 173, 52% any-grade; n = 15, 5% grade 3) and fatigue (n = 119, 36% any-grade; n = 10, 3% grade 3). The most common grade 3/4 AEs were neutropenia (n = 60, 18%) and pneumonia (n = 38, 12%). Over time, prevalence of AEs of interest (diarrhea, fatigue, grade ≥3 infection, bleeding, and neutropenia) trended down; prevalence of hypertension increased, but incidence decreased after year 1. AEs led to dose reductions in 42 (13%) patients and permanent discontinuations in 37 (11%); dose modifications due to AEs were most common during year 1 and decreased in frequency thereafter. The most common AEs (preferred term) contributing to discontinuation included pneumonia (n = 4), anemia (n = 3), and atrial fibrillation (n = 3). With long-term follow-up on PCYC-1102/1103 (ibrutinib treatment up to 67 months), grade 3/4 AEs were generally similar to those in the integrated analysis. Overall, A…
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“However, after 4 years of treatment with ibrutinib, up to 40% of patients eventually encounter treatment failure due to the development of resistance or intolerance (8).”
From Resistance Mechanisms and Approach to Chronic Lymphocytic Leukemia after BTK Inhibitor Therapy (2025) · cites this paper as [8]
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Metadata
- Authors
- Coutre, S. E., Byrd, J. C., Hillmen, P., Barrientos, J. C., Barr, P. M., Devereux, S., Robak, T., Kipps, T. J., Schuh, A., Moreno, C., Furman, R. R., Burger, J. A., O’Dwyer, M., Ghia, P., Valentino, R., Chang, S., Dean, J. P., James, D. F., & O’Brien, S. M.
- Affiliations
- Stanford Medicine (US)
- The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (US)
- Leeds Cancer Centre, St. James’s Institute of Oncology, Leeds, United Kingdom;
- Hofstra University (US)
- University of Rochester Medicine (US)
- National Health Service (GB)
- Medical University of Lodz (PL)
- University of California San Diego (US)
- National Institute for Health and Care Research (GB)
- Universitat Autònoma de Barcelona (ES)
- NewYork–Presbyterian Hospital (US)
- The University of Texas MD Anderson Cancer Center (US)
- University College Hospital Galway, Galway, Ireland;
- Vita-Salute San Raffaele University (IT)
- Pharmacyclics (United States) (US)
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA
- ORCID
- Venue
- Blood Advances
- Publisher
- American Society of Hematology
- Published
- 2019-06-13
- Volume
- 3
- Issue
- 12
- Pages
- 1799-1807
- ISSN
- 2473-9529 (ISSN-L)
- 2473-9537
- PMC
- PMC6595265
- OpenAlex
- W2952939985
- Cited by
- 134
- References
- 31
- Citations by year
- 2026: 6 · 2025: 22 · 2024: 9 · 2023: 17 · 2022: 23 · 2021: 26 · 2020: 27 · 2019: 3
- FWCI
- 10.85
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by-nc-nd
- Locations
- Blood Advances (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Archivio Istituzionale della Ricerca - Università Vita-Salute San Raffaele (submittedVersion)
- Dipòsit Digital de Documents de la UAB (Universitat Autònoma de Barcelona) (submittedVersion, public-domain)
- eScholarship (California Digital Library) (submittedVersion, cc-by)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- Pharmacyclics
- National Cancer Institute (R35CA197734, P30CA016672)
- Topics
- Health Sciences › Medicine › Hematology › Chronic Lymphocytic Leukemia Research
- Health Sciences › Medicine › Pathology and Forensic Medicine › Lymphoma Diagnosis and Treatment
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- ibrutinib, chronic lymphocytic leukemia, long-term safety, BTK inhibitors, adverse events, diarrhea, fatigue, neutropenia, pneumonia, hypertension, atrial fibrillation, dose reduction, treatment discontinuation, monotherapy
- MeSH terms
- Adenine, Adult, Aged, Aged, 80 and over, Anemia, Atrial Fibrillation, Diarrhea, Drug Tolerance, Fatigue, Female, Follow-Up Studies, Hemorrhage, Humans, Hypertension, Infections, Male, Middle Aged, Neutropenia, Piperidines, Pneumonia, Pyrazoles, Pyrimidines, Safety, Leukemia, Lymphocytic, Chronic, B-Cell, Prevalence, Protein Kinase Inhibitors
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