CLL patients with a deletion of chromosome 17p on iFISH demonstrate an aggressive course with rapid disease progression and resistance to chemotherapy. The 17p status had been previously confirmed by iFish a test that examines individual cells for chromosomal changes that are significant in predicting disease outcome The missing portion of chromosome 17 contains the gene for p53, which is one of the most important tumor suppressor genes. The Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib has demonstrated efficacy for patients with the del17p and been approved by the FDA.
In this trial, CLL patients with del17p received ibrutinib once daily until disease progression or unacceptable toxicity. 63% of patients were Rai stage III or IV and 39% had received ≥3 prior therapies. At the median follow-up of 11.5 months, the overall response rate for all patients was 83%, with a 12 month progression free survival and overall survival of 79% and 84% respectively.
These results provide further evidence of ibrutinib’s efficacy in prolonging the survival of high risk patients. For more information about available trials for CLL/SLL at Weill Cornell Medicine please follow the link to our new clinical trials listing.