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  • Huber, Henriette; Tausch, Eugen; Schneider, Christof; Edenhofer, Simone; von Tresckow, Julia; Robrecht, Sandra; Giza, Adam; Zhang, Can; Fürstenau, Moritz; Dreger, Peter; Ritgen, Matthias; Illmer, Thomas; Illert, Anna Lena; Dürig, Jan; Böttcher, Sebastian; Niemann, Carsten U; Kneba, Michael; Al-Sawaf, Othman; Kreuzer, Karl-Anton; Fink, Anna-Maria; Fischer, Kirsten; Döhner, Hartmut; Hallek, Michael; Eichhorst, Barbara; Stilgenbauer, Stephan

    Blood, 09/2023, Letnik: 142, Številka: 11
    Journal Article

    The final analysis of the open-label, multicenter phase 2 CLL2-GIVe trial shows response and tolerability of the triple combination of obinutuzumab, ibrutinib, and venetoclax (GIVe regimen) in 41 previously untreated patients with high-risk chronic lymphocytic leukemia (CLL) with del(17p) and/or TP53 mutation. Induction consisted of 6 cycles of GIVe; venetoclax and ibrutinib were continued up to cycle 12 as consolidation. Ibrutinib was given until cycle 15 or up to cycle 36 in patients not achieving a complete response and with detectable minimal residual disease. The primary end point was the complete remission rate at cycle 15, which was achieved at 58.5% (95% CI, 42.1-73.7; P < .001). The last patient reached the end of the study in January 2022. After a median observation time of 38.4 months (range, 3.7-44.9), the 36-month progression-free survival was 79.9%, and the 36-month overall survival was 92.6%. Only 6 patients continued ibrutinib maintenance. Adverse events of concern were neutropenia (48.8%, grade ≥3) and infections (19.5%, grade ≥3). Cardiovascular toxicity grade 3 occurred as atrial fibrillation at a rate of 2.4% between cycles 1 and 12, as well as hypertension (4.9%) between cycles 1 and 6. The incidence of adverse events of any grade and grade ≥3 was highest during induction and decreased over time. Progressive disease was observed in 7 patients between cycles 27 and 42. In conclusion, the CLL2-GIVe regimen is a promising fixed-duration, first-line treatment for patients with high-risk CLL with a manageable safety profile.