Abstract
Available targeted agents (TAs) for the upfront therapy of chronic lymphocytic leukemia (ie, ibrutinib, acalabrutinib, venetoclax) have rarely been compared in head-to-head clinical trials. In search of data for evidence-based treatment decisions, a systematic literature review and network meta-analysis was performed. The screening process adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guidelines (PRISMA). Only 3 trials were suitable for the base-case network analysis (ILLUMINATE, ELEVATE-TN, and CLL14). Regarding progression-free survival (PFS), fixed-effect analyses comparing ibrutinib-obinutuzumab (IO) with venetoclax-obinutuzumab (VO) (relative risk [RR], 1.52; 95% confidence interval [CI], 0.82-2.81), acalabrutinib (A) with IO (RR, 0.87; 95% CI, 0.47-1.61), and A with VO (RR, 0.57; 95% CI, 0.32-1.01) revealed that the upper limit of the 95% CI for RR did exceed the 1.0 value. This indicates a lack of significant difference in PFS for IO, VO, and A. In contrast, acalabrutinib plus obinutuzumab (AO) improved PFS in comparison with IO (RR, 0.43; 95% CI, 0.22-0.87) and VO (RR, 0.29; 95% CI, 0.15-0.56). No differences in the frequency of adverse events was observed across different TAs. Also, ...Continue Reading
References
Jan 3, 2015·Systematic Reviews·David MoherUNKNOWN PRISMA-P Group
Dec 8, 2015·The New England Journal of Medicine·Jan A BurgerUNKNOWN RESONATE-2 Investigators
Apr 30, 2017·Annals of Oncology : Official Journal of the European Society for Medical Oncology·A R MatoC Nabhan
Feb 9, 2018·Haematologica·Anthony R MatoChaitra S Ujjani
Mar 22, 2018·The New England Journal of Medicine·John F SeymourArnon P Kater
Jun 9, 2018·Haematologica·Anthony R MatoChadi Nabhan
Dec 7, 2018·The New England Journal of Medicine·Jennifer A WoyachJohn C Byrd
Dec 7, 2018·British Journal of Haematology·Jennifer R BrownJan A Burger
Dec 14, 2018·The Lancet Oncology·Carol MorenoIan W Flinn
Apr 18, 2019·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Jeff P SharmanStephan Stilgenbauer
Jun 6, 2019·The New England Journal of Medicine·Kirsten FischerMichael Hallek
Aug 1, 2019·The New England Journal of Medicine·Tait D ShanafeltMartin Tallman
Sep 12, 2019·Frontiers in Oncology·Emil Ter VeerHanneke W M van Laarhoven
Sep 13, 2019·American Journal of Hematology·Talha MunirJennifer A Woyach
Oct 20, 2019·Leukemia·Jan A BurgerThomas J Kipps
Mar 25, 2020·Blood·Eugen TauschStephan Stilgenbauer
Apr 20, 2020·Lancet·Jeff P SharmanJohn C Byrd
May 28, 2020·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Paolo GhiaWojciech Jurczak
Jun 20, 2020·Expert Opinion on Investigational Drugs·Fortunato MorabitoManlio Ferrarini
Jul 30, 2020·The New England Journal of Medicine·Jan A Burger
Jul 30, 2020·The New England Journal of Medicine·Inhye E AhnAdrian Wiestner