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EBMT 2018 | Bringing ibrutinib to the frontline of chronic GvHD treatment

Here, Steven Pavletic, MD, MS, from the National Cancer Institute, Bethesda, MD, outlines areas of improvement for treating chronic graft-versus-host disease (GvHD), the future therapeutic landscape, and encourages patient enrollment in clinical trials to help further knowledge. Dr Pavletic was speaking from the European Society for Blood and Marrow Transplantation (EBMT) 2018 Annual Meeting, held in Lisbon, Portugal.

Transcript (edited for clarity)

There are many things to be done, yes it would be important to reproduce and confirm this data in the wider clinical practice, the other question is, we still need to learn more in detail, how to deal with some safety concerns with ibrutinib, particularly infections are a concern.
There is concern about fungal infections, we have to very carefully monitor those and decide exactly what the prevention strategies should be while we are giving ibrutinib...

There are many things to be done, yes it would be important to reproduce and confirm this data in the wider clinical practice, the other question is, we still need to learn more in detail, how to deal with some safety concerns with ibrutinib, particularly infections are a concern.
There is concern about fungal infections, we have to very carefully monitor those and decide exactly what the prevention strategies should be while we are giving ibrutinib. Could we move ibrutinib into frontline therapy?
The placebo-controlled, large Phase III study is going on, and I would invite anybody to enrol patients at that study, because this is the only way we can accomplish authentic success, and finally, what I’m really interested in; could we move ibrutinib even beyond steroids in the frontline to trade frontline before you start steroids, or even maybe for prevention of chronic graft versus host disease, let’s say patients who are at high risk of relapsing for B-cell lymphoma, and at high risk of developing chronic GvHD.
Could we ultimately be at a point, it’s going to take some time, it’s going to take lots of discipline by all of us in the field to enrol patients into clinical studies.
I really would like to think that in the not-too-distant future, as a result of this trial, we’ll be able to develop strategies to prevent chronic graft versus host disease from happening at all, and really improve lives of our patients cured for hematologic malignancies.

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