@article{3032495,
    title = "Single-Agent Ibrutinib for Rituximab-Refractory Waldenstrom
Macroglobulinemia: Final Analysis of the Substudy of the Phase III
Innovate (TM) Trial",
    author = "Trotman, Judith and Buske, Christian and Tedeschi, Alessandra and and Matous, Jeffrey V. and MacDonald, David and Tam, Constantine S. and and Tournilhac, Olivier and Ma, Shuo and Treon, Steven P. and Oriol, Albert and and Ping, Jerry and Briso, Eva M. and Arango-Hisijara, Israel and and Dimopoulos, Meletios A.",
    journal = "Clinical Cancer Research",
    year = "2021",
    volume = "27",
    number = "21",
    pages = "5793-5800",
    publisher = "AMER ASSOC CANCER RESEARCH",
    issn = "1078-0432",
    doi = "10.1158/1078-0432.CCR-21-1497",
    abstract = "Purpose: The first report from the open-label substudy of the phase III
iNNOVATE study (PCYC-1127; NCT02165397) demonstrated that single-agent
ibrutinib was efficacious and well tolerated in patients with heavily
pretreated, rituximab-refractory Waldenstrom macroglobulinemia. Results
from the final analysis are now reported.
Patients and Methods: Ibrutinib 420 mg was administered once daily to
patients (N = 31) who failed to achieve at least a minor response (MR)
or who relapsed <12 months after their last rituximab-containing
therapy. Endpoints included progression-free survival (PFS) and overall
response rate (ORR; MR or better) per independent review committee,
hemoglobin improvement, overall survival (OS), and safety; serum IgM was
also assessed.
Results: After a median follow-up of 58 months (range: 9-61), median PFS
was 39 months [95% confidence interval (CI): 25-not evaluable];
60-month PFS rate was 40%. In MYD88(L265P)/CXCR4(WHIM) and
MYD88(L265P)/CXCR4(WT) subtypes, median PFS was 18 months and not
reached, respectively. In all patients, ORR was 87%; responses deepened
over time with major response (>= partial response) rates increasing
from 61% at 6 months to 77% at 60 months. Median OS was not reached.
Seventeen of 21 patients (81%) with baseline hemoglobin <= 11.0 g/dL
had sustained hemoglobin improvement. Improvements in serum IgM levels
were sustained, reaching a maximum median change of similar to 37 g/L at
54 months. Ibrutinib maintained a manageable safety profile, with no new
safety signals identified. There were no events of major hemorrhage or
atrial fibrillation.
Conclusions: In the final analysis from iNNOVATE, single-agent ibrutinib
continued to showsustained efficacy in patients with heavily pretreated,
rituximab-refractory Waldenstrom macroglobulinemia."
}