The Medical Letter on Drugs and Therapeutics
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Ibrutinib (Imbruvica) for Chronic Lymphocytic Leukemia

The FDA has approved ibrutinib (eye broo' ti nib; Imbruvica – Janssen/Pharmacyclics), an oral kinase inhibitor, for second-line treatment of chronic lymphocytic leukemia (CLL). It is the first kinase inhibitor to be approved for CLL. Ibrutinib was approved earlier for second-line treatment of mantle cell lymphoma, a rare form of B-cell non-Hodgkins lymphoma.

STANDARD TREATMENT — Initial treatment of advanced or symptomatic CLL usually consists of fludarabine, rituximab (Rituxan), and cyclophosphamide (Cytoxan, and others).1 In patients with coexisting medical conditions, who often have difficulty tolerating chemotherapy, combining rituximab with the alkylating agent chlorambucil (Leukeran) has been effective, and a recent study found that use of the newly approved anti-CD20 antibody obinutuzumab (Gazyva) with chlorambucil was even ... more      

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