Combination Treatment Improves Survival for Elderly Chronic Lymphocytic Leukemia Patients

A combination therapy of obinutuzumab (Gazyva) with chlorambucil (Leukeran) was found to prolong the overall survival of elderly chronic lymphocytic leukemia (CLL) patients compared with treatment with rituximab (Rituxan) and chlorambucil, according to a recent study.

The study, published in the March 20, 2014, edition of the New England Journal of Medicine, compared the efficacy of a combination treatment using chemotherapy agents chlorambucil and obinutuzumab versus a combination of rituximab (Rituxan) and chlorambucil, and also with chlorambucil alone for six 28-day cycles. The study included 781 patients with a median age of 73 years who had multiple clinically significant coexisting conditions.

The patients were previously untreated for CLL and had a score higher than 6 on the Cumulative Illness Rating Scale. Investigators set a primary end point of progression-free survival for the study.

Treatment with obinutuzumab—chlorambucil showed an increased response rate and prolonged progression-free survival of 26.7 months, compared with a survival rate of 16.3 months with rituximab–chlorambucil and 11.1 months with chlorambucil alone.

“Combining an anti-CD20 antibody with chemotherapy improved outcomes in patients with CLL and coexisting conditions,” the study authors conclude. “In this patient population, obinutuzumab was superior to rituximab when each was combined with chlorambucil.”