Chronic Lymphocytic Leukemia

John F. Seymour, M​BBS, FRACP, PhD, discusses the design of the phase 3 ELEVATE-RR trial comparing acalabrutinib vs ibrutinib in chronic lymphocytic leukemia.

Acalabrutinib demonstrated a lower incidence of cardiovascular-related toxicities and a lower overall toxicity burden compared with ibrutinib in patients with chronic lymphocytic leukemia.

Acalabrutinib demonstrated an advantage in quality-adjusted survival compared with other treatments for relapsed/refractory chronic lymphocytic leukemia.

High-frequency low-dose acalabrutinib and rituximab represents a feasible and effective combination for the treatment of patients with previously untreated chronic lymphocytic leukemia/small lymphocytic lymphoma.

The combination of ibrutinib and venetoclax led to a lower rate of minimal residual disease compared with fludarabine, cyclophosphamide, and rituximab in patients with treatment-naïve chronic lymphocytic leukemia, according to preliminary findings from the phase 2 ERADIC trial.

Paolo Ghia, MD, PhD, discusses the results from the minimal residual disease cohort of the phase 2 CAPTIVATE study in chronic lymphocytic leukemia that were presented during the 2021 ASH Annual Meeting & Exposition.

The addition of ibrutinib to fludarabine, cyclophosphamide, and rituximab resulted in a higher rate of complete responses with bone marrow undetectable minimal residual disease in younger, fit patients with chronic lymphocytic leukemia.

Acalabrutinib, with or without obinutuzumab, induced a significant efficacy benefit for patients with treatment-naïve chronic lymphocytic leukemia compared with ibrutinib or venetoclax plus obinutuzumab, according to findings presented during the 63rd ASH Annual Meeting and Exposition.

Ibrutinib-containing combinations demonstrated continued progression-free survival benefit compared with standard bendamustine plus rituximab in elderly patients with previously untreated chronic lymphocytic leukemia.

The results also demonstrated no significant difference in overall survival benefit between the treatment groups. However, almost all patients switched from FCR to ibrutinib or another regimen after disease relapse.

Cost and personal time spent on managing adverse effects for treatment with ibrutinib, acalabrutinib, or venetoclax could inform decision-making strategies for treatment selection in patients with chronic lymphocytic leukemia.

The addition of ublituximab and umbralisib to ibrutinib produced deep remissions with favorable tolerability in patients with chronic lymphocytic leukemia who previously received ibrutinib and still had detectable minimal residual disease.

The combinations of venetoclax plus acalabrutinib or obinutuzumab will be evaluated in the phase 3 MAJIC trial.

Quality of life improved in patients with chronic lymphocytic leukemia when treated in the frontline setting with ibrutinib-rituximab and with fludarabine, cyclophosphamide, and rituximab. Improved quality of life was also maintained during continuous therapy with ibrutinib and did not decline over time.

Real-world data of children and young adults with relapsed/refractory B-cell acute lymphoblastic leukemia treated with tisagenlecleucel demonstrated similar efficacy outcomes and a more favorable safety profile compared with the ELIANA trial.

The use of ibrutinib plus venetoclax in the first-line setting for patients with previously untreated chronic lymphocytic leukemia continues to provide deep, durable responses, according to updated results from the MRD cohort of the phase 2 CAPTIVATE trial.

The combination of obinutuzumab and venetoclax (GVe), as well as GVe plus ibrutinib demonstrated superior rates of undetectable minimal residual disease compared with chemoimmunotherapy in fit patients with chronic lymphocytic leukemia, according to findings from the phase 3 GAIA (CLL13) trial.

Frontline fixed-duration treatment with ibrutinib plus venetoclax led to deeper and prolonged rates of undetectable minimal residual disease in the bone marrow and peripheral blood, leading to fewer relapses in the first year post-treatment vs chlorambucil plus obinutuzumab in elderly and unfit patients with chronic lymphocytic leukemia.

The minimal residual disease–guided combination of ibrutinib plus venetoclax was found to be a feasible treatment regimen for patients with relapsed/refractory chronic lymphocytic leukemia.

Dr. Coombs discusses research that will be presented at the upcoming 2021 ASH Annual Meeting and Exposition in chronic lymphocytic leukemia, including that with covalent and noncovalent BTK inhibitors, COVID-19 vaccinations, and time-limited combinations.

William G. Wierda, MD, PhD, discussed the results of the phase 2 CAPTIVATE trial and the phase 1/2 TRANSCEND CLL 004 trial, and looked ahead to what the future holds for MRD in patients with CLL.

Meghan Thompson, MD, discusses the results from the use of pirtobrutinib in the phase 1/2 BRUIN study, as well as upcoming research efforts in the population of patients with Richter transformation.

Deborah M. Stephens, DO, discusses her approach to treating a patients with chronic lymphocytic leukemia, how CAR T-cell therapy may fit into the treatment paradigm, and the numerous trials that have shown promise in this space.

The FDA has scheduled a meeting of the Oncologic Drugs Advisory Committee (ODAC) to review the pending biologics license application/supplemental new drug application for the combination of ublituximab and umbralisib (Ukoniq; U2) for the treatment of adult patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma.

Deborah M. Stephens, DO, discusses early intervention with targeted agents to improve outcomes in patients with high-risk chronic lymphocytic leukemia.