iwCLL 2025 | Factors affecting the dose of ibrutinib administered to patients with CLL

Well, of course it would be great to have the full dose regimen with 420 mg for each patient when starting treatment. But of course we have to take into account many other points like the patient’s comorbidities, the patient’s medicines. Because we know that if the patient takes drugs that are really strong CYP3A inhibitors, we have to reduce the dose of ibrutinib. It would be great, as I said, that in the first few months, in the beginning of the treatment, we don’t do any dose reductions. But of course, many of these patients can deal with some kind of side effects like hypertension, atrial fibrillation, neutropenia. And in these cases, before we decide to interrupt the treatment, initially we usually do a dose reduction, and many of these patients really recover and continue even on a lower dose, or maybe in some cases we can return to the full dose of ibrutinib. There are so many reports in the last 10 years because we really have great results with ibrutinib and all other BTK drugs. So we got to know the drug. We are very familiar with it. And I don’t think that today there are many problems or more surprises with ibrutinib treatment. And many of these patients that have been using ibrutinib even on a lower dose, as some of the trials reported, continue to keep the CLL under control despite the lowered dose.

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