Efficacy of zanubrutinib versus acalabrutinib for relapsed or refractory chronic lymphocytic leukemia (R/R CLL): a matching-adjusted indirect comparison (MAIC).

IF 4.2 2区医学 Q2 ONCOLOGY

Therapeutic Advances in Medical Oncology Pub Date : 2025-07-08 eCollection Date: 2025-01-01 DOI:10.1177/17588359251340554

Mazyar Shadman, Jennifer R Brown, Rhys Williams, Leyla Mohseninejad, Keri Yang, Pal Rakonczai, Nicole Lamanna, Sheng Xu, Aileen Cleary Cohen, Susan M O'Brien, Alessandra Tedeschi, Constantine S Tam

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引用次数: 0

Abstract

Background: 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).

Objective: To compare the relative efficacy of zanubrutinib and acalabrutinib in R/R CLL using indirect treatment comparison.

Design: An unanchored matching-adjusted indirect comparison (MAIC) was performed.

Methods: 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).

Results: Post-matching, PFS-INV was improved significantly for zanubrutinib versus acalabrutinib (hazard ratio (HR) = 0.68 (95% confidence interval (CI): 0.46-0.99); p = 0.0448) and OS showed a trend toward improvement for zanubrutinib (HR = 0.60; 95% CI: 0.35-1.02, p = 0.0575). CR was significantly higher for zanubrutinib versus acalabrutinib (odds ratio = 2.90 (95% CI: 1.13-7.43); p = 0.0270).

Conclusion: Zanubrutinib was associated with a significant PFS-INV and CR advantage over acalabrutinib, with a trend toward improvement in OS.

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扎鲁替尼与阿卡拉布替尼治疗复发或难治性慢性淋巴细胞白血病（R/R CLL）的疗效：一项匹配调整的间接比较（MAIC）

背景：目前还没有比较布鲁顿酪氨酸激酶抑制剂扎鲁替尼和阿卡拉布替尼治疗复发或难治性慢性淋巴细胞白血病（R/R CLL）疗效的正面研究。目的：通过间接治疗比较，比较扎鲁替尼和阿卡拉布替尼治疗R/R CLL的相对疗效。设计：进行无锚定匹配调整间接比较（MAIC）。方法：使用预后/效应修正变量对ALPINE （zanubrutinib）的个体患者水平数据进行重新加权，以匹配ASCEND （acalabrutinib）的总体数据。MAIC结果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）。结果：配对后，zanubrutinib与acalabrutinib的PFS-INV显著改善(风险比(HR) = 0.68(95%可信区间（CI）： 0.46-0.99)；p = 0.0448)和OS显示扎鲁替尼有改善的趋势(HR = 0.60；95% CI: 0.35-1.02, p = 0.0575)。扎努鲁替尼与阿卡拉布替尼的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)。结论：Zanubrutinib与阿卡拉布替尼相比具有显著的PFS-INV和CR优势，并有改善OS的趋势。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutic Advances in Medical Oncology ONCOLOGY-

CiteScore

8.20

自引率

2.00%

发文量

160

审稿时长

15 weeks

期刊介绍： Therapeutic Advances in Medical Oncology is an open access, peer-reviewed journal delivering the highest quality articles, reviews, and scholarly comment on pioneering efforts and innovative studies in the medical treatment of cancer. The journal has a strong clinical and pharmacological focus and is aimed at clinicians and researchers in medical oncology, providing a forum in print and online for publishing the highest quality articles in this area. This journal is a member of the Committee on Publication Ethics (COPE).