Comparing chemotherapy-free treatments for patients with treatment naïve chronic lymphocytic leukemia

This study aimed to investigate three different chemotherapy-free treatment regimens for patients with chronic lymphocytic leukemia. 

This study concluded that acalabrutinib (Calquence) plus obinutuzumab (Gazyva) improved survival without cancer worsening for these patients.  

Chemotherapy-free treatment is an alternative option for the treatment of patients with treatment-naïve (previously untreated) chronic lymphocytic leukemia (CLL). Acalabrutinib, obinutuzumab, ibrutinib (Imbruvica), and venetoclax (Venclexta) are all types of targeted therapies that can be used to treat CLL. They are chemotherapy-free. 

It was unknown what combination of chemotherapy-free treatments would be suitable for patients with treatment-naïve CLL.  

This study included data from 1017 patients with CLL who were involved in 3 previous studies. One group of patients were treated with acalabrutinib and obinutuzumab (AcaObi). Another group was treated with ibrutinib and obinutuzumab (IbuObi). The final group was treated with venetoclax and obinutuzumab (VenObi). 

AcaObi treatment was associated with a 57% longer survival without cancer worsening when compared to IbuObi. AcaObi was also associated with a 70% longer survival without cancer worsening compared to VenObi.  

There was no significant overall survival advantage with AcaObi over IbuObi and VenObi groups. However, AcaObi was associated with an 87.5% probability to reach the highest overall survival among all other first-line treatments. 

There was no significant difference in side effects between the three groups. 

This study concluded that treatment with AcaObi was associated with better survival without cancer worsening when compared to IbuObi and VenObi in patients with treatment-naïve CLL.  

This study indirectly compared the 2 treatment regimens. Further controlled studies are needed to confirm these findings.