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Fraser G, Cramer P, Demirkan F, Silva RS, Grosicki S, Pristupa A, Janssens A, Mayer J, Bartlett NL, Dilhuydy MS, Pylypenko H, Loscertales J, Avigdor A, Rule S, Villa D, Samoilova O, Panagiotidis P, Goy A, Pavlovsky MA, Karlsson C, Hallek M, Mahler M, Salman M, Sun S, Phelps C, Balasubramanian S, Howes A, Chanan-Khan A. Updated results from the phase 3 HELIOS study of ibrutinib, bendamustine, and rituximab in relapsed chronic lymphocytic leukemia/small lymphocytic lymphoma. Leukemia 2019; 33:969-980. [PMID: 30315239 PMCID: PMC6484712 DOI: 10.1038/s41375-018-0276-9] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 05/09/2018] [Accepted: 08/28/2018] [Indexed: 12/21/2022]
Abstract
We report follow-up results from the randomized, placebo-controlled, phase 3 HELIOS trial of ibrutinib+bendamustine and rituximab (BR) for previously treated chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) without deletion 17p. Overall, 578 patients were randomized 1:1 to either ibrutinib (420 mg daily) or placebo, in combination with 6 cycles of BR, followed by ibrutinib or placebo alone. Median follow-up was 34.8 months (range: 0.1-45.8). Investigator-assessed median progression-free survival (PFS) was not reached for ibrutinib+BR, versus 14.3 months for placebo+BR (hazard ratio [HR] [95% CI], 0.206 [0.159-0.265]; P < 0.0001); 36-month PFS rates were 68.0% versus 13.9%, respectively. The results are consistent with the primary analysis findings (HR = 0.203, as assessed by independent review committee, with 17-month median follow-up). Median overall survival was not reached in either arm; HR (95% CI) for ibrutinib+BR versus placebo: 0.652 (0.454-0.935; P = 0.019). Minimal residual disease (MRD)-negative response rates were 26.3% for ibrutinib+BR and 6.2% for placebo+BR (P < 0.0001). Incidence of treatment-emergent adverse events (including grades 3-4) were generally consistent with the initial HELIOS report. These long-term data support improved survival outcomes and deepening responses with ibrutinib+BR compared with BR in relapsed CLL/SLL.
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Affiliation(s)
- G Fraser
- Juravinski Cancer Centre, McMaster University, Hamilton, ON, Canada.
| | - P Cramer
- Department of Internal Medicine, Center of Integrated Oncology and German CLL Study Group, University of Cologne, Cologne, Germany
| | - F Demirkan
- Division of Hematology, Dokuz Eylul University, Izmir, Turkey
| | - R Santucci Silva
- IEP São Lucas/Hemomed Oncologia e Hematologia, São Paulo, Brazil
| | - S Grosicki
- Department of Cancer Prevention, Faculty of Public Health, Silesian Medical University, Katowice, Poland
| | - A Pristupa
- Regional Clinical Hospital, Ryazan, Russia
| | - A Janssens
- Universitaire Ziekenhuizen Leuven, Leuven, Belgium
| | - J Mayer
- Department of Internal Medicine, Hematology and Oncology, Masaryk University Hospital Brno, Jihlavska, Brno, Czech Republic
| | - N L Bartlett
- Siteman Cancer Center, Washington University School of Medicine, St Louis, MO, USA
| | | | - H Pylypenko
- Department of Hematology, Cherkassy Regional Oncological Center, Cherkassy, Ukraine
| | - J Loscertales
- Hematology Department, Hospital Universitario La Princesa, IIS-IP, Madrid, Spain
| | - A Avigdor
- Division of Hematology and Bone Marrow Transplantation, Chaim Sheba Medical Center, Tel-Hashomer and Sackler School of Medicine, University of Tel-Aviv, Tel-Aviv, Israel
| | - S Rule
- Department of Haematology, Plymouth University Medical School, Plymouth, UK
| | - D Villa
- Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada
| | - O Samoilova
- Nizhny Novogorod Regional Clinical Hospital, Nizhny Novogorod, Russia
| | - P Panagiotidis
- 1st Department of Propedeutic Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Goy
- John Theurer Cancer Center at Hackensack University Medical Center, Hackensack, NJ, USA
| | - M A Pavlovsky
- Department of Hematology, Fundaleu, Buenos Aires, Argentina
| | - C Karlsson
- Department of Hematology, Karolinska University Hospital, Stockholm, Sweden
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - M Hallek
- Department I of Internal Medicine, University of Cologne, Cologne, Germany
| | - M Mahler
- Janssen Research & Development, Raritan, NJ, USA
| | - M Salman
- Janssen Research & Development, Raritan, NJ, USA
| | - S Sun
- Janssen Research & Development, Raritan, NJ, USA
| | - C Phelps
- Janssen Research & Development, Raritan, NJ, USA
| | | | - A Howes
- Janssen Research & Development, High Wycombe, UK
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Cramer P, Demirkan F, Fraser G, Pristupa A, Bartlett N, Dilhuydy M, Loscertales J, Avigdor A, Rule S, Samoilova O, Goy A, Ganguly S, Poggesi I, Lavezzi S, De Nicolao G, de Jong J, Neyens M, Salman M, Howes A, Mahler M. IBRUTINIB INCREASES THE SYSTEMIC EXPOSURE OF RITUXIMAB: PHARMACOKINETIC RESULTS FROM THE HELIOS TRIAL. Hematol Oncol 2017. [DOI: 10.1002/hon.2438_95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- P. Cramer
- Department I of Internal Medicine and German CLL Study Group; University Hospital of Cologne; Cologne Germany
| | - F. Demirkan
- Hematology; Dokuz Eylul University; Izmir Turkey
| | - G. Fraser
- Oncology; McMaster University, Juravinski Cancer Centre; Hamilton Canada
| | - A. Pristupa
- Hematology; Ryazan Regional Clinical Hospital; Ryazan Russian Federation
| | - N. Bartlett
- Medicine; Washington University School of Medicine, Siteman Cancer Center; St. Louis USA
| | - M. Dilhuydy
- Hematology and Cell Therapy, Hôpital Haut-Lévèque; Bordeaux France
| | - J. Loscertales
- Hematology; Hospital Universitario de La Princesa, IIS-IP; Madrid Spain
| | - A. Avigdor
- Hematology and Bone-Marrow Transplantation, Chaim Sheba Medical Center; Tel Hashomer Israel
| | - S. Rule
- Haematology; Derriford Hospital; Plymouth UK
| | - O. Samoilova
- Hematology; Nizhny Novgorod Regional Clinical Hospital; Nizhny Novgorod Russian Federation
| | - A. Goy
- Lymphoma; John Theurer Cancer Center at Hackensack University Medical Center; Hackensack USA
| | - S. Ganguly
- Hematologic Malignancies and Cellular Therapeutics; University of Kansas Medical Center; Kansas City USA
| | - I. Poggesi
- Clinical Pharmacology, Janssen R&D; Cologno Monzese Italy
| | - S.M. Lavezzi
- Electrical, Computer, and Biomedical Engineering, University of Pavia; Pavia Italy
| | - G. De Nicolao
- Electrical, Computer, and Biomedical Engineering, University of Pavia; Pavia Italy
| | - J. de Jong
- Clinical Pharmacology, Janssen R&D; San Diego USA
| | - M. Neyens
- Clinical Pharmacology-Pharmacometrics, Janssen R&D; Beerse Belgium
| | - M. Salman
- Clinical Oncology, Janssen R&D; Raritan USA
| | - A. Howes
- Clinical Oncology, Janssen R&D; High Wycombe UK
| | - M. Mahler
- Clinical Oncology, Janssen R&D; Raritan USA
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Delforge M, Kropff M, Spicka I, Petrucci M, Richardson PG, Schlag R, Khuageva N, Dimopoulos MA, Shpilberg O, Samoilova O, Mateos MV, Liu K, Deraedt W, van de Velde H, San Miguel J. A246 VMP Results in Fewer Bone Events and Greater ALP Increases Versus MP in the VISTA Study in Front-Line MM. ACTA ACUST UNITED AC 2009. [DOI: 10.1016/s1557-9190(11)70521-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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