Ariela Noy, MD:The open-label trial that garnered FDA approval of ibrutinib in the second-line setting included patients who had used rituximab or rituximab/chemotherapy as first-line treatment. The drug works in marginal zone lymphoma using a mechanism of action of inhibition of the protein Bruton’s tyrosine kinase.
Interestingly, a similar trial in follicular lymphoma patients was not successful. Consequently, patients with marginal zone lymphoma have a second or beyond treatment option that follicular lymphoma patients do not have. The patients who receive ibrutinib can receive treatment indefinitely. At this time, the duration of therapy is not known.
Patients who are treated with ibrutinib as second-line therapy typically have a good survival outcome. Currently, we don’t really know what that is. We only have data for about a median of 2 years. However, at least two-thirds of the patients remain without additional therapy and about 80% of the patients are alive after 3 years of follow-up.
One of the important questions that we expect to explore over the next couple of years is whether it can be used in the first-line setting. Specifically, we are about to launch a trial looking at ibrutinib in combination with rituximab. Some patients will receive rituximab alone and the others will receive rituximab and ibrutinib.
Transcript edited for clarity.
A 64-Year-Old Woman With Advanced Extranodal MZL