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真实世界中奥滨尤妥珠单抗联合维奈克拉治疗既往治疗的慢性淋巴细胞白血病或小淋巴细胞淋巴瘤患者的疗效。

Real-world evidence of obinutuzumab and venetoclax in previously treated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma.

机构信息

Department of Pharmacy, Massachusetts General Hospital, Boston, MA, USA.

Center for Lymphoma, Massachusetts General Hospital Cancer Center, Boston, MA, USA.

出版信息

Leuk Lymphoma. 2024 May;65(5):653-659. doi: 10.1080/10428194.2024.2310144. Epub 2024 Jan 31.

Abstract

Venetoclax-obinutuzumab (Ven-O) is frequently administered off-label in relapsed/refractory (r/r) CLL/SLL where venetoclax-rituximab is the approved regimen. We conducted this retrospective, real-world study to evaluate Ven-O in r/r CLL/SLL. Between 7/2019 and 6/2022, 40 patients with r/r CLL/SLL on Ven-O were included. The median age was 72, 28.2% had mutation and/or 17p deletion, median number of prior therapies was 1 (range, 1-6), and 55% had prior BTK inhibitor exposure. The overall response rate was 90% (complete response [CR] or CR with incomplete marrow recovery in 27.5% and partial response in 62.5%) of patients, and the 2-year progression-free survival was 81.2% (95% CI, 69.5-94.8). Therapy was well tolerated. No laboratory or clinical TLS occurred with venetoclax (Howard criteria). One (3%) patient experienced laboratory TLS with obinutuzumab initiation. In summary, this retrospective cohort study demonstrated that Ven-O achieves frequent, durable responses and can be safely administered in r/r CLL/SLL.

摘要

维奈托克-奥滨尤妥珠单抗(Ven-O)常在复发/难治性(r/r)慢性淋巴细胞白血病/小淋巴细胞淋巴瘤(CLL/SLL)中被超适应证使用,而维奈托克-利妥昔单抗是获批的治疗方案。我们开展了这项回顾性真实世界研究,以评估 Ven-O 在 r/r CLL/SLL 中的疗效。2019 年 7 月至 2022 年 6 月期间,40 例 r/r CLL/SLL 患者接受 Ven-O 治疗。患者中位年龄为 72 岁,28.2%有 突变和/或 17p 缺失,中位既往治疗线数为 1 线(范围,1-6 线),55%有既往 BTK 抑制剂暴露。患者的总缓解率为 90%(完全缓解[CR]或伴有不完全骨髓恢复的 CR 占 27.5%,部分缓解占 62.5%),2 年无进展生存率为 81.2%(95%CI,69.5-94.8)。治疗耐受良好。在维奈托克(Howard 标准)治疗期间未发生实验室或临床 TLS。1 例(3%)患者在奥滨尤妥珠单抗起始时发生实验室 TLS。综上,这项回顾性队列研究表明,Ven-O 可实现频繁、持久的缓解,在 r/r CLL/SLL 中可安全使用。

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