Obinutuzumab plus chlorambucil versus ibrutinib in previously untreated chronic lymphocytic leukemia patients without TP53 disruptions: A real-life CLL campus study

Obinutuzumab plus chlorambucil versus ibrutinib in previously untreated chronic lymphocytic leukemia patients without TP53 disruptions: A real-life CLL campus study

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One of the main issues in the treatment of patients with chronic lymphocytic leukemia (CLL) deals with the choice between continuous or fixed-duration therapy.Continuous ibrutinib (IB), the first-in-class BTK inhibitor, and obinutuzumab-chlorambucil (G-CHL) are commonly used therapies Nail Tools for elderly and/or comorbid patients.No head-to-head comparison has been carried out.Within the Italian campus CLL network, we performed a retrospective study on CLL patients without TP53 disruption treated with IB or G-CHL as first-line therapy.

Patients in the G-CHL arm had a higher CIRS score and the worst renal function.The overall response rates between the G-CHL and IB arms were similar, but more complete remissions (CRs) were achieved with G-CHL (p = 0.0029).After a median follow-up of 30 months, the progression-free survival (PFS, p = 0.

0061) and time to next treatment (TTNT, p = 0.0043), but not overall survival (OS, p = 0.6642), were better with IB than with G-CHL.Similar results were found after propensity score matching and multivariate analysis.

While PFS and TTNT were longer with IB than with G-CHL in IGHV unmutated patients (p = 0.0190 and 0.0137), they were superimposable for IGHV mutated patients (p = 0.1900 and 0.

1380).In the G-CHL arm, the depth of response Slide Duel Fuel Range (79% vs.68% vs.38% for CR, PR and SD/PD; p < 0.

0001) and measurable residual disease (MRD) influenced PFS (78% vs.53% for undetectable MRD vs.detectable MRD, p = 0.0203).

Hematological toxicities were common in the G-CHL arm, while IB was associated with higher costs.Although continuous IB provides better disease control in CLL, IGHV mutated patients and those achieving an undetectable MRD show a marked clinical and economic benefit from a fixed-duration obinutuzumab-based treatment.