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Ibrutinib in early stage CLL: Genetic risk factors and treatment outcome in the GCLLSG CLL12 trial - PubMed

6 hours ago
  • #Chronic Lymphocytic Leukemia
  • #Ibrutinib
  • #Genetic Risk Factors
  • Ibrutinib improves event-free survival (EFS) in early-stage CLL with intermediate to very high risk, but shows no overall survival (OS) benefit.
  • Genetic factors like del(17p), TP53 mutations, U-IGHV, and others predict poorer EFS in the placebo group, while only del(17p), TP53, and NFKBIE mutations affect EFS with ibrutinib.
  • Ibrutinib benefits EFS in subgroups with U-IGHV, del(11q), +12, NOTCH1, ATM, and NFKBIE mutations, but not in those with del(17p) or TP53 mutations.
  • Multivariable analysis identifies ibrutinib as a favorable factor for EFS, with U-IGHV, del(17p), POT1, RAS/RAF, and NFKBIE mutations as adverse prognostic factors.
  • Watch-and-wait remains standard care for early-stage CLL, particularly in high-risk cases involving del(17p) or TP53 mutations.