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Comparing the efficacy and safety of zanubrutinib to ibrutinib, the current first line treatment for chronic lymphocytic leukemia and small lymphocytic lymphoma

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Reviewed by Dat Tien Nguyen, B.A, ScM. 
Posted on February 13th, 2023
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Ibrutinib is a first generation BKT inhibitor that has been used as a first-line treatment for chronic lymphocytic leukemia and small lymphocytic lymphoma. However, the medication is not well tolerated due to its severe adverse effects. Zanubrutnib is a second generation molecule that has greater specificity to BKT. A recent study had been conducted to investigate whether the higher specificity of Zanubrutinib translated to a higher degree of efficacy and better tolerated side effects.

The phase 3 clinical trial included 652 patients who had been diagnosed with either chronic lymphocytic leukemia and small lymphocytic lymphoma. They were randomly assigned to receive 160 mg of the new agent, Zanubrutinib, twice a day or 420 mg of the current standard therapy, Ibrutinib, once a day. Treatment was given until the disease worsened or the side effects became too untolerable. The median treatment time was 29.6 months, and Zanubrutinib was more effective at delaying the development of cancerous tumors than Ibrutinib. Specifically, Zanubrutinib was far superior to the current first-line therapy in slowing down the disease progression  in patients with partial deletion of Chromosome 17, with mutation on the TP53 gene, or both. Beside the better clinical efficacy, the higher specificity of the new treatment also resulted in a better safety profile. Patients treated with Zanubrutinib experienced less severe adverse events that might result in treatment discontinuation and fewer complications to their cardiac health.
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