Updated phase 2 CAPTIVATE study results demonstrate sustained clinical benefit of fixed-duration IMBRUVICA (ibrutinib) plus venetoclax as first-line treatment for patients with chronic lymphocytic leukaemia, including those with high-risk disease
June 17, 2024 – Biotechnology, Drug Discovery –
At 5 years, 67% of patients were progression-free, with overall survival at 96% for all treated patients
14 June 2024 – Beerse, Belgium – (GLOBE NEWSWIRE) – Janssen-Cilag International NV, a Johnson & Johnson company, today announced updated findings from the phase 2 CAPTIVATE study evaluating fixed-duration (FD) IMBRUVICA (ibrutinib) in combination with venetoclax (I+V) in previously untreated patients with chronic lymphocytic leukaemia (CLL). At 5.5-years of follow-up, the FD regimen continues to demonstrate a clinically meaningful progression-free survival (PFS), both in the overall population and in those with high-risk genomic features. The data were featured in an oral presentation at the 2024 American Society of Clinical Oncology (ASCO) Annual Meeting (Abstract #7009) in Chicago from 31 May – 4 June and as an encore presentation at the European Hematology Association (EHA) Congress (Poster #P675) in Madrid, Spain, from 13-16 June 2024.
“After more than five years, the CAPTIVATE study findings confirm the sustained benefit of the fixed duration combination of ibrutinib and venetoclax as a first-line treatment for patients living with CLL, including in those with higher risk genomic features,” said Paolo Ghia MD, Università Vita- Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy, study investigator. “This all-oral, chemotherapy-free, fixed-duration regimen offers eligible patients the advantage of an extended, treatment-free interval while effectively keeping their disease under control.”
Latest findings from the multicentre phase 2 CAPTIVATE study showed that at a median follow-up of 61.2 months, 67% (95% confidence interval [CI]: 59-74) of the 159 patients treated with FD I+V, were progression-free and alive at 5-years. Notably, median PFS was not reached even after up to 5.5 years of follow-up, indicating sustained disease control.1The 5-year overall survival (OS) rate was 96% for all treated patients, while those who had high-risk genomic features (del(17p)/ mutated TP53, or complex karyotype) exhibited an OS rate of 90% (95% CI: 77-96), compared to 100% for those without these features. Moreover, for patients who achieved undetectable minimal residual disease (uMRD) status in the blood and bone marrow, this was associated with improved outcomes.1 Patients with uMRD in the bone marrow at 3-months post end of treatment (EoT+3 months) had a 5-year PFS rate of 84% (95% CI: 73-90) compared to 50% (95% CI: 36-62) for those not achieving uMRD in the bone marrow at EoT+3 months.
In the limited number of patients relapsing after FD I+V, subsequent treatment with ibrutinibbased regimens was shown to yield durable responses with an acceptable safety profile, even in patients with high-risk genomic features. Of the 61 patients with progressive disease after completion of FD I+V, 32 initiated subsequent treatment with single-agent ibrutinib (n=25) or FD I+V (n=7). With a median 21.9 months treatment on single-agent ibrutinib, 86% of patients achieved an overall response of partial response or better. With a median 13.8 months retreatment with FD I+V, the overall response rate (ORR) was 71%.
At longer follow-up, 18 second malignancies occurred in 13 patients and overall, no new safety signals were observed for FD I+V since the previous analysis. Adverse events (AEs) during subsequent treatment were consistent with the known safety profiles for single-agent ibrutinib and I+V. The most common AEs during retreatment with ibrutinib-based regimens, occurring in ≥10% of patients with single-agent ibrutinib or ≥2 patients treated with I+V, included diarrhoea, hypertension, pyrexia, upper respiratory tract infection and nausea, with serious AEs reported in five patients.
Results from six-year time to next treatment extrapolation curve for phase 3 GLOW study. The most recently reported data on long-term evidence regarding the duration of therapeutic effect associated with FD I+V in patients with previously untreated CLL includes 57 months of follow up. An extrapolation beyond the available time-to-next-treatment (TTNT) data was performed to estimate the number of patients who would be free from subsequent therapy after six years, with findings presented during a poster presentation at EHA (Poster #P699). The extrapolation indicates that at six years, approximately 87% of patients treated with the FD I+V are unlikely to require a second line treatment. These findings suggest the possibility of a long treatment-free period for patients with CLL, treated with the FD I+V regimen in the first-line setting.
“Ibrutinib is the only Bruton’s tyrosine kinase inhibitor available as both a fixed duration and continuous treatment for chronic lymphocytic leukaemia and is the most comprehensively studied medicine in its class,” said Edmond Chan MBChB MD (Res), EMEA Therapeutic Area Lead Haematology, Johnson & Johnson Innovative Medicine. “The latest data presented at EHA reinforce our commitment to advancing patient care through innovative therapies, such as ibrutinib, that can be tailored to the evolving needs and preferences of patients.”
“At Johnson & Johnson, our ultimate goal is to eliminate blood cancer, and we are inspired by the transformative impact ibrutinib-based regimens continue to have on patient outcomes,” said Mark Wildgust PhD, vice president, Global Medical Affairs, Oncology, Johnson & Johnson Innovative Medicine. “Nearly 300,000 patients worldwide have been treated with ibrutinib, and latest findings demonstrate that patients with CLL experience deep and durable responses that translate into long treatment-free periods, with the fixed duration regimen.”

