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Fraser, G; Cramer, P; Demirkan, F; Silva, R Santucci; Grosicki, S; Pristupa, A; Janssens, A; Mayer, J; Bartlett, N L; Dilhuydy, M-S; Pylypenko, H; Loscertales, J; Avigdor, A; Rule, S; Villa, D; Samoilova, O; Panagiotidis, P; Goy, A; Pavlovsky, M A; Karlsson, C; Hallek, M; Mahler, M; Salman, M; Sun, S; Phelps, C; Balasubramanian, S; Howes, A; Chanan-Khan, A
Leukemia, 04/2019, Volume: 33, Issue: 4Journal Article
We report follow-up results from the randomized, placebo-controlled, phase 3 HELIOS trial of ibrutinib+bendamustine and rituximab (BR) for previously treated chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) without deletion 17p. Overall, 578 patients were randomized 1:1 to either ibrutinib (420 mg daily) or placebo, in combination with 6 cycles of BR, followed by ibrutinib or placebo alone. Median follow-up was 34.8 months (range: 0.1-45.8). Investigator-assessed median progression-free survival (PFS) was not reached for ibrutinib+BR, versus 14.3 months for placebo+BR (hazard ratio HR 95% CI, 0.206 0.159-0.265; P < 0.0001); 36-month PFS rates were 68.0% versus 13.9%, respectively. The results are consistent with the primary analysis findings (HR = 0.203, as assessed by independent review committee, with 17-month median follow-up). Median overall survival was not reached in either arm; HR (95% CI) for ibrutinib+BR versus placebo: 0.652 (0.454-0.935; P = 0.019). Minimal residual disease (MRD)-negative response rates were 26.3% for ibrutinib+BR and 6.2% for placebo+BR (P < 0.0001). Incidence of treatment-emergent adverse events (including grades 3-4) were generally consistent with the initial HELIOS report. These long-term data support improved survival outcomes and deepening responses with ibrutinib+BR compared with BR in relapsed CLL/SLL.
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