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Obinutuzumab (Obin) plus the oral alkylating agent chlorambucil (Chl) is a standard initial treatment option for chronic lymphocytic leukemia (CLL) patients who are elderly or have coexisting illnesses. To compare response rates and outcomes with standard Obin plus Chl versus Obin plus the Bcl2 inhibitor venetoclax (Ven), investigators conducted an industry-funded, international, randomized, phase III trial in 432 previously untreated patients with coexisting illness and Cumulative Illness Rating Scale scores >6. Twelve 28-day cycles were administered, with no crossover upon disease progression or therapy-related toxicity.
The rate of complete remission was improved with Ven/Obin versus Chl/Obin (49.5% vs. 23.1%; P<0.001). At a median follow…