Progression-free survival increased with zanubrutinib in leukemia

Progression-free survival was significantly longer with zanubrutinib than with ibrutinib among patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), according to a study published online Dec. 13 in New England Journal of Medicine.

Jennifer R. Brown, MD, Ph.D., of the Dana-Farber Cancer Institute in Boston, and colleagues randomly assigned patients with relapsed or refractory CLL or SLL who had received one prior course of therapy to receive either zanubrutinib or ibrutinib until disease progression or unacceptable toxic effects. Progression-free survival was assessed to determine whether zanubrutinib was non-inferior to ibrutinib in this final analysis; superiority of zanubrutinib was assessed if non-inferiority was established.

The researchers found that among 652 patients, zanubrutinib was superior to ibrutinib in terms of progression-free survival during a median follow-up of 29.6 months (hazard ratio for disease progression or death, 0.65), as assessed by the researchers. At 24 months, the estimated progression-free survival rates were 78.4 and 65.9 percent in the zanubrutinib and ibrutinib groups, respectively. Longer progression-free survival was observed for those receiving zanubrutinib versus ibrutinib among patients with a 17p deletion, TP53 mutation, or both (hazard ratio for disease progression or death, 0.53); in other major subgroups, progression-free survival was consistently favored by zanubrutinib. The safety profile of zanubrutinib was better than that of ibrutinib.

“Advantages in progression-free survival and overall response were observed in all major subgroups, including high-risk patients,” the authors write.

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