Oral Therapy for Chronic Lymphocytic Leukemia in Older Patients and Those with Comorbidities

Bruton tyrosine kinase inhibitors (BTKis) have largely supplanted chemo-immunotherapy in the frontline treatment of chronic lymphocytic leukemia (CLL). Given the further improvement in responses when BTKis are combined with the anti-CD20 monoclonal antibody obinutuzumab or the B-cell lymphoma-2 (BCL2) inhibitor venetoclax, investigators assessed efficacy and safety in older patients and those with comorbidities.

In a phase 3, multicenter, industry-sponsored trial, 211 previously untreated patients older than 65 or younger than 65 and with Cumulative Illness Rating Scale (CIRS) scores >6 were randomized to ibrutinib plus venetoclax or chlorambucil plus obinutuzumab. Patients received three 4-week cycles of daily ibrutinib followed by 12 cycle…