ASH 2019: New CLL Data Show Sustained Efficacy with Targeted Combo Therapies

Jennifer Woyach, MD, associate professor at The Ohio State University, gives an overview of the new data in chronic lymphocytic leukemia being presented at the 2019 American Society of Hematology Annual Meeting and Exposition.

This ASH, with the exception of the ELEVATE TN data, which is the acalabrutinib frontline study, so that was chlorambucil plus obinutuzumab versus acalabrutinib plus obinutuzumab versus acalabrutinib alone, which showed a significant advantage in progression-free survival for the 2 acalabrutinib-containing arms versus chlorambucil/obinutuzumab. That was probably the most practice changing and most important thing in my mind to come out of ASH this year. We’re seeing a lot of data following up from studies that we had heard before in more preliminary forums, follow-up on MD Anderson’s ibrutinib and venetoclax study, the initial look at the CAPTIVATE study, and the follow-up on the ECOG 1912 study and the CLL14 trial.

So all of those follow-ups kind of confirmed what we had seen in the original report, which is great. So with CLL14, our previous data, so that was chlorambucil plus obinutuzumab versus venetoclax plus obintuzumab, and on both arms it was 12 months of therapy and previously we had follow-up of a total of 24 months. So a year on treatment and a year off treatment. Now that’s actually been extended to another year off treatment and the progression-free survival curves are still looking really good. So I think we can be more comfortable choosing that regimen for our patients knowing that they’re not going to likely progress very quickly, especially if they get a deep response.

Then with ECOG1912, that was a study comparing FCR to ibrutinib plus rituximab (IR). We got again another follow-up of another year on that study again showing the trend toward, or the significant advantage, in both progression-free and overall survival with IR versus FCR.