Clearly idelalisib improved overall survival when added to bendamustine (Bendetta/Treanda)/rituximab (Rituxan). These results are similar to those from the HELIOS trial reported at last year’s ASCO meeting,” said Susan O’Brien, MD, Associate Director for Clinical Science for the Chao Family Comprehensive Cancer Center and Medical Director of the Sue and Ralph Stern Center for Cancer Clinical Trials and Research at the University of California, Irvine.

HELIOS had a similar design and sought to determine whether ibrutinib (Imbruvica) added benefit to bendamustine/rituximab in a similar study population, although that trial excluded patients with a 17p deletion.

“At ASCO 2015, the discussant of the HELIOS trial, Lloyd ­Damon, MD [Director of Blood and Marrow Transplant and Hematologic Malignancies and Chief of the Hematology Clinic at the University of California, San Francisco, Medical Center] raised a question that also pertains to the current trial, which is whether this well-conducted, large, randomized, controlled trial with an independent review committee asked the right question. With the long-term data that we have on ibrutinib  [Imbruvica] alone, the question is whether we really need chemotherapy,” Dr. O’Brien added.

“I think we could ask the same question about this trial; clearly idelalisib adds chemotherapy, but are the results better than what we would have gotten with idelalisib (and rituximab) alone? It is possible that with longer follow-up, there could be more complete remissions with the addition of the chemotherapy—or this might not be the case,” she stated. ■

Disclosure: Dr. O’Brien reported no potential conflicts of interest.