Department I of Internal Medicine and Center of Integrated Oncology Cologne-Bonn, German CLL Study Group, University of Cologne, Cologne, Germany
Von Tresckow Julia , Paula Cramer , Jasmin Bahlo , Sandra Robrecht , Othman Al-Sawaf , Petra Langerbeins , Moritz Fürstenau , Anja Engelke , Anna-Maria Fink , Kirsten Fischer , Karl A Kreuzer , Matthias Ritgen , Sebastian Boettcher , Clemens Martin Wendtner , Stephan Stilgenbauer , Barbara Eichhorst , Michael J. Hallek
Background: The German CLL study group (GCLLSG) performed three similar phase-II-trials combining a CD20-antibody, ofatumumab (O) or obinutuzumab (G, for GA-101), with ibrutinib (I) or venetoclax (A) in an all-comer population of treatment-naïve or relapsed/refractory CLL patients (pts). Methods: In all 3 trials, pts with high tumor burden received optional bendamustine debulking (BD). Subsequent induction therapy consisted of 6 cycles of I plus O (BIO trial), or I plus G (BIG) or A plus G (BAG). Induction therapy was followed by a maintenance phase using the same drugs until achieving a minimal residual disease (MRD) negative complete remission or up to 24 months. The primary endpoint was the overall response rate (ORR) at the end of induction; secondary endpoints were MRD and safety. Results: 66 pts each were enrolled in the 3 trials. Pts with < 2 induction cycles were excluded from the analysis as per protocol, resulting in 65, 61 and 63 evaluable pts in BIO, BIG and BAG, respectively. The primary endpoint was met in all trials. BD achieved an ORR of 61 % across all trials. During combination therapy one fatal adverse event occurred in each trial; during induction 46 SAEs occurred in BIO, 29 in BIG and 59 in BAG. Patients? characteristics and major results are shown in the Table. Conclusions: The sequential combination concept shows very good efficacy and tolerability. BD reduced the number of IRR. Combination therapies with G seemed more efficient when compared to O. Additionally, combining A plus G seemed to evoke deeper responses than I plus G. Clinical trial information: NCT02689141, NCT02401503 and NCT02345863
BIO | BIG | BAG | |
---|---|---|---|
Patients (N) | 65 | 61 | 63 |
Median age (years) | 61 | 66 | 59 |
Prior therapies (median) | 1.5 | 1.0 | 2.0 |
TP53 mutations or del(17p) | 21 (32%) | 13 (21%) | 17 (28%) |
CLL-IPI high or very high risk | 42 (67%) | 41 (67%) | 38 (63%) |
Response | |||
ORR | 60 (92%) | 61 (100%) | 60 (95%) |
Complete remission (CR) | 0 | 0 | 5 (8%) |
Clinical CR or CR with incomplete recovery of the marrow | 20 (31%) | 28 (46%) | 20 (32%) |
MRD negative ( < 10-4) after induction | 9 (14%) | 29 (48%) | 55 (87%) |
Infusion related reactions during induction (CTC gr. 1 4) | |||
with BD | 17 (33%) | 13 (29%) | 13 (28%) |
without BD | 8 (57%) | 10 (59%) | 7 (37%) |
Tumor lysis syndrome during induction (CTC gr. 1 4) | |||
with BD | 0 | 1 (2%) | 1 (2%) |
without BD | 0 | 0 | 1 (5%) |
Disclaimer
This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org
Abstract Disclosures
2022 ASCO Annual Meeting
First Author: Kerry Anne Rogers
2023 ASCO Annual Meeting
First Author: Paul M. Barr
2023 ASCO Annual Meeting
First Author: Anna Maria Frustaci
2023 ASCO Annual Meeting
First Author: Kerry Anne Rogers