International Journal of Hematology and Oncology 2022, Vol 32, Num 2 (Special Issue) Page(s): 004-014
Ibrutinib: From Molecule to Medicine

Orhan AYYILDIZ1, Fatih DEMIRKAN2, Hakan GOKER3, Ibrahim C. HAZNEDAROGLU3, Osman ILHAN4, Leyla G. KAYNAR5, Evren OZDEMIR6, Guray SAYDAM7, Nilgun SAYINALP3, Fahri SAHIN7, Mehmet TURGUT8, Ali UNAL5, Filiz VURAL7

1Dicle University Faculty of Medicine, Department of Internal Medicine, Diyarbakir
2Dokuz Eylul University Faculty of Medicine, Department of Hematology, Izmir
3Hacettepe University Faculty of Medicine, Department of Hematology, Ankara
4Ankara University Faculty of Medicine, Ibn-i Sina Hospital, Department of Internal Medicine, Ankara
5Erciyes University Faculty of Medicine, Department of Hematology, Kayseri
6Hacettepe University Faculty of Medicine, Department of Oncology, Ankara
7Ege University Faculty of Medicine, Department of Hematology, Izmir
8Ondokuz Mayis University Faculty of Medicine, Department of Hematology, Samsun, TURKEY

Keywords: Ibrutinib, CLL, BCR, BTK
Bruton’s tyrosine kinase (BTK) inhibitor Ibrutinib (PCI-32765) is a novel targeted-therapeutic agent modulating BCR, which serves as a covalent irreversible inhibitor of BTK. Ibrutinib significantly alters the composition of the tumor microenvironment in CLL, affecting soluble as well as cellular molecular elements without myelosupression. Ibrutinib is clinically developed as an orally administered anti-cancer agent with lead indications in relapse/refractory and in treatment-naïve patients with B-cell malignancies as a single agent. The clinical activities of Ibrutinib as a drug were shown in the B-cell malignancies, especially in patients with CLL, mantle cell lymphoma (MCL), and Waldenstrom’s macroglobulinemia (WM). Ibrutinib has generated the most extensive results so far in patients with CLL, predominately refractory or relapsed CLL where durable disease control as well as improved progression-free survival (PFS) and overall survival (OS) has been observed. The aim of this review is to outline the pharmacophysiological basis of Ibrutinib treatment as well as the current clinical experience based on the trials. The treatment algorithms of B-lymphoproliferative diseases will continue to be revised to a more personalized approach to treat with improved efficacy devoid of unnecessary toxicity.