A Meta-analysis Investigating Response Rates with Continuous Bruton Tyrosine Kinase Inhibitor Monotherapies in the Treatment of B Cell Lymphomas.

IF 3.4 Q2 ONCOLOGY
Oncology and Therapy Pub Date : 2026-06-01 Epub Date: 2026-03-07 DOI:10.1007/s40487-026-00425-y
Pier Luigi Zinzani, Rhys Williams, Mei Xue, Binod Neupane, Priccila Zuchinali, Kyle Fahrbach, Heather Burnett, Dennis Sadic, Leyla Mohseninejad, Keri Yang
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引用次数: 0

Abstract

Introduction: Bruton tyrosine kinase inhibitor (BTKi) monotherapies have improved patient outcomes in B cell lymphomas; however, evidence on their comparative efficacy remains limited. This meta-analysis compared the efficacy of BTKi monotherapies across treatment naïve (TN) and/or relapsed and refractory (R/R) B cell lymphomas.

Methods: Clinical trials reporting complete response (CR) or overall response rate (ORR) for zanubrutinib, acalabrutinib, or ibrutinib monotherapy in chronic lymphocytic leukemia (CLL), marginal zone lymphoma (MZL), mantle cell lymphoma (MCL), or Waldenström macroglobulinemia (WM) were included. Response rates from similar duration of follow-up were pooled across applicable studies. Naïve odds ratios (ORs) comparing CR and ORR of zanubrutinib with acalabrutinib or ibrutinib were calculated within each B cell lymphoma indication and then meta-analyzed across all indications using a random effects model.

Results: The meta-analysis found zanubrutinib to be associated with statistically significant improvements in investigator-assessed CR and ORR vs acalabrutinib and ibrutinib across B cell lymphomas, using data with similar duration of follow-up. The pooled OR estimates [95% CI] for CR were 1.80 [1.03, 3.13] for zanubrutinib vs acalabrutinib and 2.85 [1.16, 7.04] for zanubrutinib vs ibrutinib across all B cell indications. ORs significantly favored zanubrutinib over acalabrutinib and ibrutinib for R/R MCL, and over ibrutinib for R/R MZL. The pooled OR estimates for ORR were 1.59 [1.00, 2.53] for zanubrutinib vs acalabrutinib and 2.25 [1.40, 3.61] for zanubrutinib vs ibrutinib. ORs significantly favored zanubrutinib over acalabrutinib and ibrutinib for TN CLL, and over ibrutinib for R/R MCL and R/R MZL.

Conclusion: Consistent with the results of existing head-to-head trials, zanubrutinib demonstrated either numerically or statistically significant improved CR and ORR compared to acalabrutinib and ibrutinib across B cell lymphomas. Similar trends were observed within each indication. These findings suggest that zanubrutinib is the most effective BTKi treatment option for patients across B cell lymphomas.

一项荟萃分析调查持续布鲁顿酪氨酸激酶抑制剂单一疗法治疗B细胞淋巴瘤的反应率。
布鲁顿酪氨酸激酶抑制剂(BTKi)单一疗法改善了B细胞淋巴瘤患者的预后;然而,关于它们的相对疗效的证据仍然有限。该荟萃分析比较了BTKi单药治疗naïve (TN)和/或复发和难治性(R/R) B细胞淋巴瘤的疗效。方法:纳入报告zanubrutinib、acalabrutinib或ibrutinib单药治疗慢性淋巴细胞白血病(CLL)、边缘区淋巴瘤(MZL)、套细胞淋巴瘤(MCL)或Waldenström巨球蛋白血症(WM)完全缓解(CR)或总缓解率(ORR)的临床试验。相似随访时间的应答率汇总在适用的研究中。Naïve在每个B细胞淋巴瘤适应症中计算zanubrutinib与acalabrutinib或ibrutinib的CR和ORR的比值比(ORs),然后使用随机效应模型对所有适应症进行meta分析。结果:荟萃分析发现,与阿卡拉布替尼和伊鲁替尼相比,扎努布替尼在B细胞淋巴瘤中具有统计学上显著的改善,随访时间相似。在所有B细胞适应症中,zanubrutinib vs acalabrutinib的合并OR估计[95% CI]为1.80 [1.03,3.13],zanubrutinib vs ibrutinib的合并OR估计[95% CI]为2.85[1.16,7.04]。对于R/R型MCL, or比阿卡拉布替尼和伊鲁替尼更青睐扎鲁替尼,对于R/R型MZL, or比伊鲁替尼更青睐扎鲁替尼。zanubrutinib与acalabrutinib的ORR合并OR估计为1.59 [1.00,2.53],zanubrutinib与ibrutinib的ORR合并OR估计为2.25[1.40,3.61]。相比阿卡拉布替尼和依鲁替尼,对于TN型CLL,对于R/R型MCL和R/R型MZL, or更倾向于扎鲁替尼。结论:与现有的头对头试验结果一致,与阿卡拉布替尼和依鲁替尼相比,zanubrutinib在B细胞淋巴瘤上的CR和ORR的改善在数值上或统计学上都具有显著意义。在每个指标中都观察到类似的趋势。这些发现表明,扎鲁替尼是B细胞淋巴瘤患者最有效的BTKi治疗选择。
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来源期刊
CiteScore
3.40
自引率
0.00%
发文量
31
审稿时长
6 weeks
期刊介绍: Now indexed in PubMed Aims and Scope Oncology and Therapy is an international, peer reviewed, rapid-publication (peer review in 2 weeks, published 3–4 weeks from acceptance) journal dedicated to the publication of high-quality pre-clinical, clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of therapeutics and interventions (including devices) across all therapeutic areas. Studies relating to diagnostics and diagnosis, pharmacoeconomics, public health, epidemiology, quality of life, and patient care, management, and education are also encouraged. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Oncology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of clinical therapies. Personal Service The journal’s dedicated in-house editorial team offer a personal “concierge service” meaning that authors will always have a personal point of contact able to update them on the status of their manuscript. The editorial team check all manuscripts to ensure that articles conform to the most recent COPE, GPP and ICMJE publishing guidelines. This supports the publication of ethically sound and transparent research. We also encourage pre-submission enquiries and are always happy to provide a confidential assessment of manuscripts. Digital features and plain language summaries Oncology and Therapy offers a range of additional features designed to increase the visibility, readership and educational value of the journal’s content. Each article is accompanied by key summary points, giving a time-efficient overview of the content to a wide readership. Articles may be accompanied by plain language summaries to assist readers who have some knowledge of, but not in-depth expertise in, the area to understand the scientific content and overall implications of the article. The journal also provides the option to include various types of digital features including animated abstracts, video abstracts, slide decks, audio slides, instructional videos, infographics, podcasts and animations. All additional features are peer reviewed to the same high standard as the article itself. If you consider that your paper would benefit from the inclusion of a digital feature, please let us know. Our editorial team are able to create high-quality slide decks and infographics in-house, and video abstracts through our partner Research Square, and would be happy to assist in any way we can. For further information about digital features, please contact the journal editor (see ‘Contact the Journal’ for email address), and see the ‘Guidelines for digital features and plain language summaries’ document under ‘Submission guidelines’. Preprints We encourage posting of preprints of primary research manuscripts on preprint servers, authors'' or institutional websites, and open communications between researchers whether on community preprint servers or preprint commenting platforms. Posting of preprints is not considered prior publication and will not jeopardize consideration in our journals. Please see here for further information on preprint sharing: https://www.springer.com/gp/authors-editors/journal-author/journal-author-helpdesk/submission/1302#c16721550 Peer Review Process Upon submission, manuscripts are assessed by the editorial team to ensure they fit within the aims and scope of the journal and are also checked for plagiarism. All suitable submissions are then subject to a comprehensive single-blind peer review. Reviewers are selected based on their relevant expertise and publication history in the subject area. The journal has an extensive pool of editorial and advisory board members who have been selected to assist with peer review based on the afore-mentioned criteria. At least two extensive reviews are required to make the editorial decision, with the exception of some article types such as Commentaries, Editorials and Letters which are generally reviewed by one member of the Editorial Board. Where reviewer recommendations are conflicted, the editorial board will be contacted for further advice and a presiding decision. Manuscripts are then either accepted, rejected or authors are required to make major or minor revisions (both reviewer comments and editorial comments may need to be addressed). Once a revised manuscript is re-submitted, it is assessed along with the responses to reviewer comments and if it has been adequately revised it will be accepted for publication. Accepted manuscripts are then copyedited and typeset by the production team before online publication. Appeals against decisions following peer review are considered on a case by case basis and should be sent to the journal editor. Copyright Oncology and Therapy''s content is published open access under the Creative Commons Attribution-Noncommercial License, which allows users to read, copy, distribute, and make derivative works for non-commercial purposes from the material, as long as the author of the original work is cited. The author assigns the exclusive right to any commercial use of the article to Springer. For more information about the Creative Commons Attribution-Noncommercial License, click here: http://creativecommons.org/licenses/by-nc/4.0 Publication Fees Upon acceptance of an article, authors will be required to pay the mandatory Rapid Service Fee of £3650/€4500/$5100. The journal will consider fee discounts for developing countries and this is decided on a case by case basis. Open Access All articles published by Oncology and Therapy are published open access Contact For more information about the journal, including pre-submission enquiries, please contact managing editor Lydia Alborn at lydia.alborn@springer.com.
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