Triplet Therapy for High-Risk Chronic Lymphocytic Leukemia

Front-line treatment with a Bruton tyrosine kinase inhibitor (BTKi) is the standard of care for patients with symptomatic, advanced-stage chronic lymphocytic leukemia (CLL) and adverse biomarkers, including unmutated IGHV, del(11q), complex karyotype, and del(17p) and/or mutated TP53. However, the latter two biomarkers are associated with poorer outcomes with single-agent BTKi.

Now, investigators have conducted a multicenter, open-label trial (CLL2-GIVe) to test whether combining agents with distinct mechanisms of action might improve outcomes for 41 previously untreated CLL patients with del(17p) and/or TP53 mutation. The regimen comprised induction with obinutuzumab, venetoclax, and ibrutinib; consolidation with 6 cycles of ibrutinib and v…