All content on this site is intended for healthcare professionals only. By acknowledging this message and accessing the information on this website you are confirming that you are a Healthcare Professional. If you are a patient or carer, please visit the Lymphoma Coalition.
Introducing
Now you can personalise
your Lymphoma Hub experience!
Bookmark content to read later
Select your specific areas of interest
View content recommended for you
Find out moreThe Lymphoma Hub website uses a third-party service provided by Google that dynamically translates web content. Translations are machine generated, so may not be an exact or complete translation, and the Lymphoma Hub cannot guarantee the accuracy of translated content. The Lymphoma Hub and its employees will not be liable for any direct, indirect, or consequential damages (even if foreseeable) resulting from use of the Google Translate feature. For further support with Google Translate, visit Google Translate Help.
The Lymphoma & CLL Hub is an independent medical education platform, sponsored by Beigene and Roche, and supported through educational grants from Bristol Myers Squibb, Ipsen Biopharmaceuticals, Lilly, Pfizer, and Pharmacyclics LLC, an AbbVie Company and Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC View funders.
Bookmark this article
Test your knowledge! Take our quick quiz before and after you read this article to find out if you improved your knowledge. Results help us to improve content and continually provide open-access education.
Bruton kinase inhibitors such as ibrutinib have significantly improved the treatment landscape of chronic lymphocytic leukemia (CLL). Ibrutinib and venetoclax, a B-cell lymphoma 2 inhibitor, are complementary in their mode of action; phase II studies have shown deep, durable responses, and improvements in progression-free survival (PFS), including in patients with high-risk CLL disease.
The Lymphoma Hub has previously reported findings from the GLOW trial. Here, we summarize a recently published article by Niemann et al.1 in The Lancet Oncology on the 4-year follow-up of the phase III GLOW trial (NCT03462719) investigating fixed duration ibrutinib + venetoclax vs chlorambucil + obinutuzumab in patients with previously untreated CLL.
GLOW is a randomized, multicenter study conducted across 14 countries in patients with previously untreated CLL. Eligible patients were aged ≥65 years or 18–64 years with comorbidities (cumulative illness rating scale score of >6/creatinine clearance of <70 mL/min), or both and had an Eastern Cooperative Oncology Group performance status of ≤2. Patients were randomized as shown in Figure 1.
The primary endpoint was PFS assessed by an independent review committee, defined as the time from randomization until disease progression or death from any cause.
Secondary endpoints included:
Figure 1. Treatment schema*
OD, once daily.
*Adapted from Niemann, et al.1
A total of 211 patients received ibrutinib + venetoclax (n = 106) and chlorambucil + obinutuzumab (n = 105). The baseline characteristics are summarized in Table 1.
Table 1. Baseline characteristics*
Characteristic, % (unless otherwise stated) |
Ibrutinib + venetoclax arm |
Chlorambucil + |
|
Median age, years |
71 |
71 |
|
Sex |
|
|
|
Male |
55.7 |
60.0 |
|
ECOG PS 1−2 |
67.0 |
62.9 |
|
Median CIRS score, n |
9 |
8 |
|
>6† |
69.8 |
58.1 |
|
Median CrCL, mL/min |
66.5 |
63.2 |
|
Rai stage III–IV |
57.3 |
52.5 |
|
Bulky disease ≥5 cm |
39.0 |
36.2 |
|
Elevated LDH† |
33.0 |
48.6 |
|
IGHV status‡ |
|
|
|
Mutated |
30.2 |
33.3 |
|
Unmutated |
63.2 |
54.3 |
|
Unknown |
6.6 |
12.4 |
|
Del(11q) |
18.9 |
17.1 |
|
TP53 mutation |
6.6 |
1.9 |
|
CIRS, cumulative illness rating scale; CrCL, creatinine clearance; ECOG PS, Eastern Cooperative Oncology Group performance status; IGHV, immunoglobulin heavy chain variable region gene; IQR, interquartile range; LDH, lactate dehydrogenase. |
At a median follow-up of 46 months:
Figure 2. 42-month PFS in ibrutinib + venetoclax arm vs chlorambucil + obinutuzumab arm*
PFS, progression-free survival.
*Adapted from Niemann et al.1
The 4-year follow-up data of the GLOW trial demonstrated that fixed-duration ibrutinib + venetoclax continues to significantly improve PFS and achieve an OS advantage compared with chlorambucil + obinutuzumab in patients with previously untreated CLL. The findings support the clinical use of this combination regimen as a first-line treatment option in patients with CLL.
Supported by an educational grant from Janssen Biotech, Inc., administered by Janssen Scientific Affairs, LLC. All content is developed by SES in collaboration with an expert steering committee; funders are allowed no influence on the content of this resource.
Understanding your specialty helps us to deliver the most relevant and engaging content.
Please spare a moment to share yours.
Please select or type your specialty
Your opinion matters
Subscribe to get the best content related to lymphoma & CLL delivered to your inbox