Evidence Level:Sensitive: A2 - Guideline
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Excerpt:Chronic Lymphocytic Leukemia/Small Lymphocytic Lymphoma...SUGGESTED TREATMENT REGIMENS...CLL/SLL with del(17p)/TP53 mutation…Other recommended regimens…Ibrutinib + venetoclax…
Evidence Level:Sensitive: C2 – Inclusion Criteria
Title:
Venetoclax and Ibrutinib in Treating Patients With Chronic or Small Lymphocytic Leukemia
Excerpt:...- Cohort 2: Untreated patients with high-risk features (del(17p), or mutated TP53, or del(11q), or unmutated IGHV, or >= 65 years of age) are eligible (cohort 2) provided they have active disease requiring treatment as defined by the International Working Group for CLL (IWCLL)...
Evidence Level:Sensitive: C2 – Inclusion Criteria
Title:
Ibrutinib lead-in Followed by Venetoclax Plus Ibrutinib in Patients With RR CLL
Excerpt:...- Cytologically and immunophenotypically confirmed relapsed/refractory CLL (irrespective of the 17p deletion and/or TP53 mutation status and the duration of remission from last prior therapy)...
Less C2 evidence
Evidence Level:Sensitive: C3 – Early Trials
Title:
4635 Combined Ibrutinib and Venetoclax for First-Line Treatment of Patients with Chronic Lymphocytic Leukemia (CLL): 5-Year Follow-up Data
Excerpt:We report long term follow-up of combined IBR and VEN in first-line CLL (n=120) with a 5-year PFS of 90.1%. The 5-year PFS for pts with del(17p)/TP53 mutation is 86.1%. Retreatment with BTK inhibitor appears effective for pts with disease relapse.
Evidence Level:Sensitive: C3 – Early Trials
Title:
Fixed-duration ibrutinib + venetoclax for first-line treatment of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): 4-y follow-up from the FD cohort of the phase 2 CAPTIVATE study.
Excerpt:Pts aged ≤70 y with previously untreated CLL/SLL received 3 cycles of I then 12 cycles of I+V (I 420 mg/d orally; V ramp-up to 400 mg/d orally)….4 y PFS rates were numerically lower in pts with uIGHV (73%) or del(17p) and/or TP53 mutation (63%), while OS rates remained consistently high (Table)....With 4 y follow-up, fixed-duration I+V continues to provide deep, durable remissions with clinically meaningful PFS and time off treatment, including in pts with high-risk disease features.
DOI:10.1200/JCO.2023.41.16_suppl.7535
Evidence Level:Sensitive: C3 – Early Trials
Title:
Ibrutinib Plus Venetoclax for First-line Treatment of Chronic Lymphocytic Leukemia
Excerpt:Patients were required to have at least 1 of the following features: del(17p), TP53-mutated CLL, del(11q)...Therapy consisted of ibrutinib, 420 mg/d, monotherapy for 3 cycles, thereafter combined with venetoclax....The 3-year progression-free survival was 93%, and 3-year overall survival was 96%....Remissions appeared to be durable during a follow-up of more than 3 years, with activity seen across high-risk disease subgroups, including those with del(17p)/TP53-mutated CLL.
DOI:10.1001/jamaoncol.2021.1649
Evidence Level:Sensitive: C3 – Early Trials
Title:
032 | CAPTIVATE PRIMARY ANALYSIS OF FIRST-LINE TREATMENT WITH FIXED-DURATION IBRUTINIB PLUS VENETOCLAX FOR CHRONIC LYMPHOCYTIC LEUKEMIA (CLL)/SMALL LYMPHOCYTIC LYMPHOMA (SLL)
Excerpt:Eligible pts were aged ≤70 y and had not received previous treatment for CLL/SLL. Pts received 3 cycles of I then 12 cycles of I+V (I 420 mg/d orally; V ramp-up to 400 mg/d orally)….In the 27 pts with del(17p)/TP53 mutation, CR rate was 56%...
DOI:https://doi.org/10.1002/hon.2879
Evidence Level:Sensitive: C3 – Early Trials
Title:
Fixed-duration (FD) first-line treatment (tx) with ibrutinib (I) plus venetoclax (V) for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): Primary analysis of the FD cohort of the phase 2 captivate study.
Excerpt:In pts with del(17p)/TP53 mutation (n=27), CR rate was 56%, uMRD rate was 81% (PB) and 41% (BM), and 24-mo PFS was 84% (95% CI 63–94). Of 34 pts with high baseline TLS risk based on tumor burden, 32 (94%) shifted to medium or low risk after I lead-in; no TLS occurred....First-line I+V is an all-oral, once-daily, chemotherapy-free, fixed-duration regimen that provides deep, durable responses in pts with CLL/SLL, including those with genomic high-risk features.
DOI:10.1200/JCO.2021.39.15_suppl.7501
Evidence Level:Sensitive: C3 – Early Trials
Title:
Fixed-duration (FD) first-line treatment (tx) with ibrutinib (I) plus venetoclax (V) for chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL): Primary analysis of the FD cohort of the phase 2 captivate study.
Excerpt:In pts with del(17p)/TP53 mutation (n=27), CR rate was 56%, uMRD rate was 81% (PB) and 41% (BM), and 24-mo PFS was 84% (95% CI 63–94)….First-line I+V is an all-oral, once-daily, chemotherapy-free, fixed-duration regimen that provides deep, durable responses in pts with CLL/SLL, including those with genomic high-risk features.
DOI:10.1200/JCO.2021.39.15_suppl.7501
Evidence Level:Sensitive: C3 – Early Trials
Title:
Ibrutinib (Ibr) Plus Venetoclax (Ven) for First-Line Treatment of Chronic Lymphocytic Leukemia (CLL)/Small Lymphocytic Lymphoma (SLL): Results from the MRD Cohort of the Phase 2 CAPTIVATE Study
Excerpt:The high rates of BM uMRD were consistent across high-risk subgroups, including in pts with del(17p) (75%), del(17p) or TP53 mutation (70%), del(11q) (84%), complex karyotype (83%), and unmutated IGHV status (81%)...First-line treatment with Ibr + Ven represents an all oral, once-daily, chemotherapy-free regimen that provides high rates of uMRD in both PB and BM in pts with CLL.
DOI:https://doi.org/10.1182/blood-2019-121424
Evidence Level:Sensitive: C4 – Case Studies
Title:
THE RESULTS OF THERAPY IN PATIENTS WITH B-CELL LYMPHOID MALIGNANCIES WITH MUTATIONS IN THE TP53 GENE
Excerpt:...patient with CLL - in as a first-line therapy ibrutinib with venetoclax was administered before allo-HCT...Five out of 8 patients remain in complete remission of the disease without signs of GVHD with follow-up from 1 to 52 months.