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Jeremy S. Abramson, MD, MMSc
Jeremy S. Abramson, MD, MMSc
Posted: Tuesday, January 21, 2025
Zanubrutinib was more effective than ibrutinib in Chinese patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to an analysis of the Chinese subgroup of the ALPINE phase III trial by Lugui Qiu, MD, of the Chinese Academy of Medical Sciences and Peking Medical College, Tianjin, and colleagues. The research was published in Annals of Hematology.
“Despite differences in demographic and disease characteristics between the Chinese population subgroup and the overall population of ALPINE, efficacy results consistently favored zanubrutinib over ibrutinib in both populations,” the investigators commented.
The global ALPINE phase III trial compared the Bruton’s tyrosine kinase inhibitors zanubrutinib and ibrutinib in patients with relapsed or refractory CLL or small lymphocytic leukemia. The study included 652 patients, 90 of them from China. Patients were randomly assigned 1:1 to receive oral zanubrutinib at 160 mg twice per day or oral ibrutinib at 420 mg once per day, stratified by age, refractory status, del(17p)/TP53 mutation status, and China vs non-China.
In the Chinese subgroup, zanubrutinib conveyed a benefit to progression-free survival (84%) compared with ibrutinib (56%). This was comparable to the full study, for which the results were 78% and 66%, respectively. The zanubrutinib arm also had a higher overall response rate (81%) than the ibrutinib arm (72%). This was also comparable to the full study, for which the results were 84% and 74%, respectively. Patients in the zanubrutinib arm had lower rates of treatment discontinuation (15%) and serious adverse events (64%) than patients in the ibrutinib arm (42% and 72%, respectively).
The Chinese subgroup was younger (median age, 60.5 years) than the full study population (median age, 67 years), with a greater proportion of higher disease stages and del(17p) or TP53 mutations. The authors noted that the Chinese subgroup was not large enough to draw statistical conclusions.
Disclosure: For full disclosures of the study authors, visit link.springer.com.
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