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Zanubrutinib for Resistant CLL and Small Lymphocytic Lymphoma

By: Julia Fiederlein
Posted: Friday, July 24, 2020

In a multicenter phase II study, zanubrutinib seemed to achieve high overall response rates in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), according to Jianyong Li, MD, PhD, of The First Affiliated Hospital of Nanjing Medical University, China, and colleagues. The results, which were published in the Journal of Hematology and Oncology, suggested treatment with this Bruton tyrosine kinase inhibitor was also well tolerated in these patients.

“Bruton tyrosine kinase inhibitors have demonstrated a high degree of efficacy in the treatment of B-cell malignancies characterized by constitutive B-cell receptor activation, including CLL [and] SLL,” the investigators commented. “As a selective Bruton tyrosine kinase inhibitor with favorable pharmacokinetic and pharmacodynamic properties, zanubrutinib offers the potential for improved safety and tolerability over existing treatment options and thereby potentially confers a favorable benefit-risk profile for patients with [these malignancies].”

A total of 91 Chinese patients with relapsed or refractory CLL (n = 82) or SLL (n = 9) who received at least one prior line of standard chemotherapy were enrolled. Each patient was administered 160 mg of zanubrutinib twice daily in 28-day cycles. Follow-up data were provided for an average of 15.1 months.

The investigators reported an overall response rate of 84.6%, including 3.3% with a complete response, 59.3% with a partial response, and 22% with a partial response with lymphocytosis. At 12 months, the investigators estimated an event-free rate for the duration of response of 92.9%. Neutropenia (44%), thrombocytopenia (15.4%), lung infection or pneumonia (13.2%), upper respiratory tract infection (9.9%), and anemia (8.8%) were among the most commonly reported adverse events of grade 3 or higher. The overall survival rate was 96% at 12 months. Of the evaluable patients, seven required at least one dose reduction, and eight discontinued zanubrutinib due to adverse reactions.

Disclosure: For full disclosures of the study authors, visit jhoonline.biomedcentral.com.



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