Zanubrutinib Monotherapy for Naive and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma: A Pooled Analysis of Three Studies

Xu, W; Yang, S; Tam, CS; Seymour, JF; Zhou, K; Opat, S; Qiu, L; Sun, M; Wang, T; Trotman, J; Pan, L; Gao, S; Zhou, J; Zhou, D; Zhu, J; Song, Y; Hu, J; Feng, R; Huang, H; Su, D; Shi, M; Li, J

Author(s): Xu, W; Yang, S; Tam, CS; Seymour, JF; Zhou, K; Opat, S; Qiu, L; Sun, M; Wang, T; Trotman, J; Pan, L; Gao, S; Zhou, J; Zhou, D; Zhu, J; Song, Y; Hu, J; Feng, R; Huang, H; Su, D; Shi, M; Li, J;
Details: Publication Year 2022-09,Volume 39,Issue #9,Page 4250-4265
Journal Title: Advances in Therapy
Publication Type: Research article
Abstract: INTRODUCTION: Zanubrutinib is a highly selective irreversible inhibitor of Bruton tyrosine kinase which has shown significant activity in lymphoid malignancies in early phase studies. We report here the long-term follow-up outcomes of zanubrutinib in various lines of therapy in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). METHODS: This post hoc analysis pooled patients with treatment-naive (TN) or relapsed/refractory (R/R) CLL/SLL receiving zanubrutinib monotherapy from three phase 1/2 studies (BGB-3111-1002, BGB-3111-AU-003, BGB-3111-205). RESULTS: A total of 211 patients with CLL/SLL (TN 19, R/R 192) were included. After weighting (TN 19, R/R 24), the overall response rate (ORR) was 95.4% and significantly higher in the TN group than in the R/R group (100 vs. 91.0%, p < 0.0001). ORR was also significantly higher in the TN group than in the one prior line of therapy group (100 vs. 98.9%, p < 0.0001). Among those with R/R disease, the ORR was 97.8% in patients with one prior line of therapy (n = 79) and 90.7% in those with > 1 prior lines of therapy (n = 85; p = 0.080). The median follow-up times were 50.1, 35.7, and 45.9 months for TN, R/R and all cohorts, respectively. Progression-free survival and overall survival were significantly longer in the TN group and only one prior line of therapy group compared with the > 1 prior lines of therapy group (all p < 0.05) and were similar in the TN group compared with the one prior line therapy group. Efficacy was similar regardless of the presence of genomic aberrations. Most frequent grade >/= 3 adverse events were infections (41.7%), neutropenia (34.1%), and thrombocytopenia (9.4%). Atrial fibrillation occurred in only 1.9% of patients. CONCLUSIONS: With extended follow-up, zanubrutinib yielded long-term benefits and demonstrated a favorable safety profile for patients with TN or RR CLL/SLL. Earlier utilization of zanubrutinib was associated with better outcomes. TRIAL REGISTRATION: Clinical Trials.gov identifiers, NCT03189524, NCT02343120 (retrospectively registered), and NCT03206918 (retrospectively registered).
Keywords: Humans; *Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy; *Lymphoma, B-Cell/drug therapy; Piperidines/adverse effects; Pyrazoles/adverse effects; Pyrimidines/adverse effects; Cll/sll; Overall response rate; Post hoc analysis; Zanubrutinib
Department(s): Haematology
PubMed ID: 35900694
Publisher's Version: https://doi.org/10.1007/s12325-022-02238-7
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2025-05-16 01:15:10

Last Modified: 2025-05-16 01:16:07