Study Identifies Survival Gains Among 11 First-Line CLL Treatments

For first-line treatment of chronic lymphocytic leukemia (CLL), acalabrutinib-plus-obinutuzumab was associated with higher proportions of 5-year progression-free survival than ibrutinib but not acalabrutinib, ibrutinib-plus-obinutuzumab, ibrutinib-plus-rituximab, or venetoclax-plus-obinutuzumab, according to results from a network meta-analysis of survival curves published online ahead of print in Clinical Lymphoma, Myeloma, & Leukemia.

“Overall, only acalabrutinib-plus-obinutuzumab was associated with superior 5-year progression-free survival gains over ibrutinib, which in turn was similar or superior in progression-free survival benefit over other targeted therapies,” reported researchers from the University of Arizona.

The analysis included eight trials that spanned 11 treatments for patients with CLL ineligible for fludarabine.

The study also found that patients with unmutated IGHV had higher proportions of progression-free survival with acalabrutinib, acalabrutinib-plus-obinutuzumab, and ibrutinib-plus-obinutuzumab compared with ibrutinib. Furthermore, in patients with del 17p, targeted therapies were superior to chemoimmunotherapies.

Targeted therapies containing ibrutinib or acalabrutinib regimens had superior time-to-next-treatment compared with venetoclax-plus-obinutuzumab and all chemoimmunotherapies, according to the analysis.

“Despite marked 5-year overall survival for many regimens,” researchers wrote, “a differential 5-year overall survival benefit could not be ascertained.”

Reference:
Alrawashdh N, Persky DO, McBride A, Sweasy J, Erstad B, Abraham I. Comparative Efficacy of First-Line Treatments of Chronic Lymphocytic Leukemia: Network Meta-Analyses of Survival Curves [published online ahead of print, 2021 Jun 23]. Clin Lymphoma Myeloma Leuk. 2021;S2152-2650(21)00239-1. doi:10.1016/j.clml.2021.06.010