Real-World Evidence on Ibrutinib in First-Line Chronic Lymphocytic Leukemia/ Small Lymphocytic Lymphoma: A Comprehensive Review.

Ibrutinib, a Bruton tyrosine kinase inhibitor, is a cornerstone of first-line treatment for chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). While generally well tolerated, dose adjustments may be used in some patients to manage adverse events or tolerability issues. This review examines the real-world outcomes such as the effectiveness and duration of therapy of first-line ibrutinib treatment in patients with CLL/SLL, including those with high-risk genomic features. The role of flexible dosing strategies, including dose adjustments or interruptions, and their role in optimizing ibrutinib treatment duration and outcomes are explored. Consistent with results from clinical trials, real-world evidence supports the effectiveness of ibrutinib dosing flexibility in managing adverse events while maintaining long-term clinical benefits. Ibrutinib dose adjustments help optimize treatment persistence and reduce treatment discontinuations, thereby enabling continuous ibrutinib treatment. Furthermore, real-world evidence suggests that ibrutinib dose flexibility contributes to reduced healthcare resource utilization, including fewer hospitalizations and outpatient visits, thus lowering the economic burden of CLL/SLL treatment. Long-term effectiveness, together with lower costs and the ability to tailor ibrutinib dosing to individual patients, supports ibrutinib as a pivotal agent in the management of CLL/SLL.