Dr. Dimopoulos Reflects on Ibrutinib Plus Rituximab in Waldenstrom Macroglobulinemia

Meletios Dimopoulos, MD, professor and chairman, Department of Clinical Therapeutics at the University of Athens School of Medicine, Athens, Greece, discusses the impact of the results from the iNNOVATE study of ibrutinib (Imbruvica) plus rituximab (Rituxan) in patients with Waldenström macroglobulinemia (WM).

The combination of ibrutinib and rituximab lowered the risk of disease progression or death by 80% versus rituximab alone in patients with WM, and at a median follow-up of 26.5 months, the median progression-free survival was not reached with the ibrutinib combination and was 20.3 months with rituximab alone (HR, 0.20; 95% CI, 0.11-0.38, P <.0001). The findings led to the FDA approval of this combination for all patients with WM.

A minority of patients with WM harbor mutations at MYD88and CXCR4. Dimopoulos says that this study showed that with the combination of ibrutinib and rituximab, the adverse effect of these mutations was reversed. The combination of ibrutinib and rituximab is now a new standard of care for the treatment of patients with this disease, Dimopoulos says, but in the future, he would like to increase the depths of response.