In a nutshell
This study wanted to compare the effectiveness of chlorambucil (Leukeran) plus either obinutuzumab (Gazyva) or rituximab (Rituxan) in the treatment of frail patients with chronic lymphocytic leukemia (CLL). Researchers found that chlorambucil with obinutuzumab (G-Clb) was more effective than with rituximab (R-Clb) in these patients.
Some background
Chronic lymphocytic leukemia is a cancer of the bone marrow. This affects the immune system leading to abnormal cells. Treatment often targets the abnormal cells in different ways. It is important to compare the effectiveness of different treatments. This is often measured by the minimal residual disease (MRD). This is the number of abnormal cells left in the body during or after treatment.
Most studies regarding CLL medications are done on young patients without any additional medical conditions. However, most patients with CLL are over 65 years of age and likely have other illnesses. The safety and effectiveness of drug combinations in these patients remain under investigation.
Methods & findings
663 patients with CLL who completed treatment were included in this study. 333 received G-Clb and 330 received R-Clb. 474 patients had their blood samples analyzed after treatment. MRD of patients was split into groups of positive, intermediate, and undetectable. Patients were followed up for an average of 65.6 months.
At the end of treatment, 90 (19%) patients were MRD-undetectable. 132 (27.8%) were MRD-intermediate, and 252 (53.2%) were MRD-positive. MRD response was linked to overall survival. MRD-undetectable was more common in patients on G-Clb (35.8%) compared to R-Clb (3.3%). Survival without the disease worsening was longer in patients treated with G-Clb (57.3 months) compared to R-Clb (35.6 months)
The bottom line
The study concluded that MRD was a good measure of survival outcomes in patients with CLL. It also concluded that G-Clb was a more effective treatment than R-Clb in frail patients with CLL.
The fine print
More patients received the G-Clb treatment which may have affected results.
Published By :
Blood
Date :
Nov 19, 2018
