DOSING FOR WM1

Convenient one tablet, once-a-day dosing

Dosing to fit your patient's routine1

Continue IMBRUVICA® treatment until disease progression or unacceptable toxicity.

Dosing to fit your patient's routine1

  • May be coadministered with proton pump inhibitors2,3
  • No dose adjustments required with acid-reducing agents2,3
  • Modify dose or avoid IMBRUVICA® use with CYP3A inhibitors and avoid coadministration with strong CYP3A inducers
  • Flexibility to take at home

For more customized patient management, IMBRUVICA® for WM can be dosed as a single 420-mg tablet or three 140-mg capsules1

*Agents administered in combination with IMBRUVICA® require infusion. When administering IMBRUVICA® in combination with rituximab or obinutuzumab, consider administering IMBRUVICA® prior to rituximab or obinutuzumab when given on the same day.

  • Administer IMBRUVICA® at approximately the same time each day with a glass of water
  • Swallow tablets or capsule whole. Do not open, break, or chew the capsules. Do not cut, crush, or chew the tablets
  • If a dose of IMBRUVICA® is not taken at the scheduled time, it can be taken as soon as possible on the same day with a return to the normal schedule the following day. Do not take extra doses of IMBRUVICA® to make up for the missed dose

Once-daily dosing is necessary to ensure inhibition of BTK enzymatic activity1

 

Inhibition of BTK by IMBRUVICA® has a disruptive effect on 3 key B-cell processes as shown by in vitro and in vivo studies1:

  1. Inhibits survival and proliferation1,4-8
  2. Inhibits adhesion1,8-13
  3. Modulates chemotaxis and trafficking1,7,9,11,13-16

Correlation to clinical effect has not been established.

BTK=Bruton’s tyrosine kinase, WM=Waldenström's Macroglobulinemia

References: 1IMBRUVICA® (ibrutinib) Prescribing Information. 2de Jong J, Haddish Berhane N, Hellemans P, Jiao J, Sukbuntherng J, Ouellet D. The pH-altering agency omerprazole affects rate but not the extent of ibrutinib exposure. Cancer Chemoth Pharm. 2018;82:299-308. 3Marostica E, Sukbuntherng J, Loury D, et al. Population pharmacokinetic model of ibrutinib, a Bruton tyrosine kinase inhibitor, in patients with B cell malignancies. Cancer Chemoth Pharm. 2015;75:111-121. 4Burger JA, Buggy JJ. Bruton tyrosine kinase (BTK) inhibitor ibrutinib (PCI-32765). Leuk Lymphoma. 2013;54(11):2385-2391. 5Honigberg LA, Smith AM, Sirisawad M, et al. The Bruton tyrosine kinase inhibitor PCI-32765 blocks B-cell activation and is efficacious in models of autoimmune disease and B-cell malignancy. Proc Natl Acad Sci USA. 2010;107(29):13075-13080. 6Cinar M, Hamedani F, Mo Z, et al. Bruton tyrosine kinase is commonly overexpressed in mantle cell lymphoma and its attenuation by ibrutinib induces apoptosis. Leuk Res. 2013;37(10):1271-1277. 7Ponader S, Chen S-S, Buggy JJ, et al. The Bruton tyrosine kinase inhibitor PCI-32765 thwarts chronic lymphocytic leukemia cell survival and tissue homing in vitro and in vivo. Blood. 2012;119(5):1182-1189. 8Herman SEM, Gordon AL, Hertlein E, et al. Bruton tyrosine kinase represents a promising therapeutic target for treatment of chronic lymphocytic leukemia and is effectively targeted by PCI-32765. Blood. 2011;117(23):6287-6296. 9Chang BY, Francesco M, Steggerda S, et al. Ibrutinib inhibits malignant cell adhesion and migration and reduces tumor burden in lymph node and bone marrow in a murine model of mantle cell dissemination and progression. Presented at: 104th Annual Meeting of the American Association for Cancer Research; April 6-10, 2013; Washington, DC. Abstract 923. 10Binsky I, Lantner F, Grabovsky V, et al. TAp63 regulates VLA-4 expression and chronic lymphocytic leukemia cell migration to the bone marrow in a CD74-dependent manner. J Immunol. 2010;184(9):4761-4769. 11Kurtova AV, Tamayo AT, Ford RJ, Burger JA. Mantle cell lymphoma cells express high levels of CXCR4, CXCR5, and VLA-4 (CD49d): importance for interactions with the stromal microenvironment and specific targeting. Blood. 2009;113(19):4604-4613. 12Chang BY, Francesco M, de Rooij MFM, et al. Egress of CD19+CD5+ cells into peripheral blood following treatment with the Bruton tyrosine kinase inhibitor ibrutinib in mantle cell lymphoma patients. Blood. 2013;122(14):2412-2424. 13de Rooij MFM, Kuil A, Geest CR, et al. The clinically active BTK inhibitor PCI-32765 targets B-cell receptor- and chemokine-controlled adhesion and migration in chronic lymphocytic leukemia. Blood. 2012;119(11):2590-2594. 14Kindt TJ, Goldsby RA, Osborne BA. Kuby Immunology. 6th ed. New York, NY: W.H. Freeman; 2007. 15Burger JA, Ghia P, Rosenwald A, Caligaris-Cappio F. The microenvironment in mature B-cell malignancies: a target for new treatment strategies. Blood. 2009;114(16):3367-3375. 16Davids MS, Burger JA. Cell trafficking in chronic lymphocytic leukemia. Open J Hematol. 2012;3(S1)-3. Published online February 21, 2012.