Shadman Mazyar, Brown Jennifer R, Williams Rhys, Mohseninejad Leyla, Yang Keri, Rakonczai Pal, Lamanna Nicole, Xu Sheng, Cleary Cohen Aileen, O'Brien Susan M, Tedeschi Alessandra, Tam Constantine S
Fred Hutchinson Cancer Center and University of Washington, 825 Eastlake Ave. E. Seattle, Seattle, WA 98109-1023, USA.
Division of Medical Oncology, Chronic Lymphocytic Leukemia Center, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA, USA.
Ther Adv Med Oncol. 2025 Jul 8;17:17588359251340554. doi: 10.1177/17588359251340554. eCollection 2025.
There are no head-to-head studies comparing the efficacy of the Bruton tyrosine kinase inhibitors, zanubrutinib and acalabrutinib, in relapsed or refractory chronic lymphocytic leukemia (R/R CLL).
To compare the relative efficacy of zanubrutinib and acalabrutinib in R/R CLL using indirect treatment comparison.
An unanchored matching-adjusted indirect comparison (MAIC) was performed.
Individual patient-level data from ALPINE (zanubrutinib) were reweighted using prognostic/effect-modifying variables to match aggregate data from ASCEND (acalabrutinib). MAIC outcomes included investigator-assessed progression-free survival (PFS-INV), overall survival (OS), and complete response (CR).
Post-matching, PFS-INV was improved significantly for zanubrutinib versus acalabrutinib (hazard ratio (HR) = 0.68 (95% confidence interval (CI): 0.46-0.99); = 0.0448) and OS showed a trend toward improvement for zanubrutinib (HR = 0.60; 95% CI: 0.35-1.02, = 0.0575). CR was significantly higher for zanubrutinib versus acalabrutinib (odds ratio = 2.90 (95% CI: 1.13-7.43); 0.0270).
Zanubrutinib was associated with a significant PFS-INV and CR advantage over acalabrutinib, with a trend toward improvement in OS.
尚无头对头研究比较布鲁顿酪氨酸激酶抑制剂泽布替尼和阿卡拉布替尼在复发或难治性慢性淋巴细胞白血病（R/R CLL）中的疗效。
采用间接治疗比较法比较泽布替尼和阿卡拉布替尼在R/R CLL中的相对疗效。
进行了一项无锚定匹配调整间接比较（MAIC）。
使用预后/效应修饰变量对来自ALPINE（泽布替尼）的个体患者水平数据进行重新加权，以匹配来自ASCEND（阿卡拉布替尼）的汇总数据。MAIC结局包括研究者评估的无进展生存期（PFS-INV）、总生存期（OS）和完全缓解（CR）。
匹配后，泽布替尼对比阿卡拉布替尼的PFS-INV显著改善（风险比（HR）=0.68（95%置信区间（CI）：0.46-0.99）；P=0.0448），OS显示泽布替尼有改善趋势（HR=0.60；95%CI：0.35-1.02，P=0.0575）。泽布替尼的CR显著高于阿卡拉布替尼（优势比=2.90（95%CI：1.13-7.43）；P=0.0270）。
与阿卡拉布替尼相比，泽布替尼具有显著的PFS-INV和CR优势，OS有改善趋势。
