Comparing the effectiveness of venetoclax to other antitumor therapies in treating chronic lymphocytic leukemia
|
Reviewed by Dat Tien Nguyen, B.A, ScM.
Translated by An Duc Thien Le |
Posted on June 5th, 2023
|
Previous clinical studies have found that the combination of venetoclax and obinutuzumab is effective in enhancing the progression-free survival time in patients diagnosed with chronic lymphocytic leukemia (CLL). However, little is known about the efficacy of this combination relative to other first-line therapy. Thus, a randomized, controlled study was conducted to compare the health outcomes of CLL patients treated with the venetoclax-obinutuzumab combo to other recommended regimens.
The phase 3 clinical trial included 926 patients who were previously diagnosed with chronic lymphocytic leukemia but have been untreated. These patients have an average age of 61 years old, and they are not heavily burdened by other coexisting morbidities. The trial participants was randomly assigned to 4 different combination of treatment: 1) venetoclax-rituximab; 2) venetoclax–obinutuzumab; 3) venetoclax–obinutuzumab–ibrutinib; 4) standard chemoimmunotherapy care of fludarabine, cyclophosphamide, and bendamustine. The presence of cancerous lymphocytes was detected using flow cytometry. After 15 months of treatment, the researchers concluded that the combination of venetoclax–obinutuzumab, with or without the BTK-inhibitor (ibrutinib), significantly suppressed the proliferation of leukemia lymphocyte cells when compared to the standard chemoimmunotherapy. When comparing regimens with different CD20 inhibitors, the researchers did not find significant differences in the clearance of leukemia lymphocyte cells between those that used obinutuzumab versus those that used rituximab. In addition, the researchers noted that, after 3 years, both of the venetoclax–obinutuzumab regimens, with and without ibrutinib, were more effective at inhibiting disease progression than standard care. They were also more effective at preventing disease progression after 3 years than the combination of venetoclax and rituximab. Thus, it seems like the venetoclax–obinutuzumab combination was the most effective at treating chronic lymphocytic leukemia. However, adverse events were reported in 21.2% of those who were treated with venetoclax–obinutuzumab and ibrutinib; this was significantly higher than those who was treated with the standard chemoimmunotherapy (18.5%), the venetoclax–rituximab (10.5%), and the venetoclax–obinutuzumab (13.2%). Thus, it seems like the addition of ibrutinib to the venetoclax–obinutuzumab might have caused an excessive amount of side effects; further researchers are needed to investigate if this supplementation added to the clinical benefit.
The phase 3 clinical trial included 926 patients who were previously diagnosed with chronic lymphocytic leukemia but have been untreated. These patients have an average age of 61 years old, and they are not heavily burdened by other coexisting morbidities. The trial participants was randomly assigned to 4 different combination of treatment: 1) venetoclax-rituximab; 2) venetoclax–obinutuzumab; 3) venetoclax–obinutuzumab–ibrutinib; 4) standard chemoimmunotherapy care of fludarabine, cyclophosphamide, and bendamustine. The presence of cancerous lymphocytes was detected using flow cytometry. After 15 months of treatment, the researchers concluded that the combination of venetoclax–obinutuzumab, with or without the BTK-inhibitor (ibrutinib), significantly suppressed the proliferation of leukemia lymphocyte cells when compared to the standard chemoimmunotherapy. When comparing regimens with different CD20 inhibitors, the researchers did not find significant differences in the clearance of leukemia lymphocyte cells between those that used obinutuzumab versus those that used rituximab. In addition, the researchers noted that, after 3 years, both of the venetoclax–obinutuzumab regimens, with and without ibrutinib, were more effective at inhibiting disease progression than standard care. They were also more effective at preventing disease progression after 3 years than the combination of venetoclax and rituximab. Thus, it seems like the venetoclax–obinutuzumab combination was the most effective at treating chronic lymphocytic leukemia. However, adverse events were reported in 21.2% of those who were treated with venetoclax–obinutuzumab and ibrutinib; this was significantly higher than those who was treated with the standard chemoimmunotherapy (18.5%), the venetoclax–rituximab (10.5%), and the venetoclax–obinutuzumab (13.2%). Thus, it seems like the addition of ibrutinib to the venetoclax–obinutuzumab might have caused an excessive amount of side effects; further researchers are needed to investigate if this supplementation added to the clinical benefit.