BRUIN 313 and 314 Trials Open the Door for Noncovalent Bruton Tyrosine Kinase Inhibition as Initial Therapy for Chronic Lymphocytic Leukemia
Menés respectivement sur 662 et 282 patients atteints d'un lymphome à petits lymphocytes ou d'une leucémie lymphoïde chronique réfractaire ou récidivante, ces deux essais randomisés comparent l'efficacité, du point de vue du taux de réponse globale et de la survie sans progression, et la toxicité, d'une part du pirtobrutinib et de l'ibrutinib en traitement de première ligne, et d'autre part du pirtobrutinib et d'un traitement combinant bendamustine et rituximab
Over the past decade, the treatment landscape for chronic lymphocytic leukemia (CLL) has evolved rapidly with the approval of three oral, covalent Bruton tyrosine kinase inhibitors (cBTKi)—ibrutinib, acalabrutinib, and zanubrutinib—which were all previously shown to lead to superior progression-free survival (PFS; and in some cases overall survival [OS]) compared with chemoimmunotherapy when given as continuous therapies in the treatment-naïve (TN) setting.1-3 Time-limited targeted regimens incorporating the oral B-cell leukemia/lymphoma-2 inhibitor (BCL-2i) venetoclax as a backbone, combined with anti-CD20 monoclonal antibodies such as obinutuzumab,4 cBTKi,5 or all three mechanisms together,6 have also now become standard frontline treatment options.
Journal of Clinical Oncology , éditorial, 2025