Second-Generation Bruton's Tyrosine Kinase Inhibitors: Simply the Best Treatments for Chronic Lymphocytic Leukemia?
Mené sur 533 patients atteints d'une leucémie lymphoïde chronique, cet essai de phase III évalue la non-infériorité, du point de vue de la survie sans progression, et la toxicité de l'acalabrutinib par rapport à l'ibrutinib (durée médiane de suivi : 40,9 mois)
Ibrutinib is the oral, covalently binding inhibitor of Bruton's tyrosine kinase (BTK) that revolutionized therapy for patients with chronic lymphocytic leukemia (CLL). Ibrutinib's significant efficacy and enhanced tolerability compared with standard chemoimmunotherapy regimens were driving factors in the shift to targeted therapies as the preferred CLL treatment option for most patients.1-3 For a period, ibrutinib was considered optimal therapy for many patients with CLL. As ibrutinib is intended to be taken continuously for an indefinite period, tolerability of the drug is quite important. With longer follow-up, notable toxicities were documented for patients with CLL, including atrial fibrillation (11%-16%) and hypertension (20%-26%).1,2 Toxicities were cited as the cause of ibrutinib discontinuation in up to 28% of patients in phase III studies.1 With the goals of maintaining the efficacy seen with ibrutinib but reducing toxicity through more selective BTK inhibition, second-generation BTK inhibitors were developed.
Journal of Clinical Oncology , 2021