ibrutinib (Imbruvica)
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Indications
- treatment of mantle cell lymphoma
- for patients with prior treatment failure
- treatment of chronic lymphocytic leukemia
- for patients with prior treatment failure
- untreated older patients (>=65 years)[4]
- treatment of Waldenstrom's macroglobulinemia
Dosage
Capsules: 140 mg
Adverse effects
- common
- skin eruptions are seen in up to 47% of patients[7]
- thrombocytopenia, neutropenia, anemia, fatigue, musculoskeletal pain, edema, upper respiratory infection, nausea, vomiting, constipation, diarrhea, bruising, dyspnea, rash, abdominal pain, decreased appetite
- other
- bleeding, infections, nephrotoxicity, other malignancy
- atrial fibrillation[3]
- serious infections (11%) 1/3 are invasive fungal infections[3]
- initial increase in lymphocyte count when used to treat CLL[5]
- ibrutinib impairs ability of lymphocytes to home to lymph nodes, spleen & bone marrow
- cardiotoxicity[6]
- hypertension[6]
Mechanism of action
- Bruton tyrosine kinase (BTK) inhibitor[3]
More general terms
References
- ↑ FDA News Release: Nov. 13, 2013 FDA approves Imbruvica for rare blood cancer. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm374761.htm
- ↑ FDA News Release: Feb. 12, 2014 FDA approves Imbruvica to treat chronic lymphocytic leukemia. http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm385764.htm
- ↑ 3.0 3.1 3.2 3.3 Varughese T, Taur Y, Cohen N et al. Serious infections in patients receiving ibrutinib for treatment of lymphoid cancer. Clin Infect Dis 2018 Aug 16; 67:687. PMID: https://www.ncbi.nlm.nih.gov/pubmed/29509845 https://academic.oup.com/cid/article-abstract/67/5/687/4917700
- ↑ 4.0 4.1 Ingram I Ibrutinib Alone Wins in Older CLL Patients. Adding rituximab offered no added benefit. MedPage Today. Dec 01, 2018 https://www.medpagetoday.com/meetingcoverage/ashhematology/76642
Woyach JA, Ruppert AS, Heerema NA et al. Ibrutinib regimens versus chemoimmunotherapy in older patients with untreated CLL. N Eng J Med. Dec 1, 2018 PMID: https://www.ncbi.nlm.nih.gov/pubmed/30501481 https://www.nejm.org/doi/full/10.1056/NEJMoa1812836 - ↑ 5.0 5.1 Geriatric Review Syllabus, 10th edition (GRS10) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2019
- ↑ 6.0 6.1 6.2 Jenkins K Ibrutinib Cardiotoxicity: Worse Than With Chemo? High rates of adverse events with so-called targeted therapy. MedPage Today. September 25, 2019 https://www.medpagetoday.com/hematologyoncology/leukemia/82379
Salem JE, Manouchehri A, Bretagne M et al Cardiovascular Toxicities Associated With Ibrutinib J Am Coll Cardiol 74(13): October 2019 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/31558250 <Internet> http://www.onlinejacc.org/content/74/13/1667
Bergler-Klein J Real-Life Insight Into Ibrutinib Cardiovascular Events Defining the Loose Ends. J Am Coll Cardiol 74(13): October 2019 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/31558251 <Internet> http://www.onlinejacc.org/content/74/13/1679 - ↑ 7.0 7.1 Mohammed ET, Patel T Asymptomatic Purpuric Eruption on the Scalp of a Middle-aged Man. JN Learning. JAMA Oncology February 18, 2021 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33599695 https://edhub.ama-assn.org/jn-learning/module/2776412
- ↑ Medscape: ibrutinib (Rx) https://reference.medscape.com/drug/imbruvica-ibrutinib-999896#0
- ↑ Highlights of Prescribing Information http://www.accessdata.fda.gov/drugsatfda_docs/label/2013/205552lbl.pdf
Patient information
ibrutinib oral (Imbruvica) patient information