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Zanubrutinib versus acalabrutinib in R/R CLL: an indirect comparison
On February 29, 2024, it was announced that zanubrutinib demonstrated improved progression-free survival and complete response versus acalabrutinib in a recent matching adjusted indirect comparison (MAIC) analysis. The MAIC analysis was based on the efficacy outcomes of zanubrutinib versus acalabrutinib from the phase III ALPINE and ASCEND trials in patients with relapsed or refractory chronic lymphocytic leukemia.
The individual patient-level data from ALPINE was matched against the aggregate data from the ASCEND trial. Key results from the indirect comparison were as follows:
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Improved investigator-assessed progression-free survival for zanubrutinib versus acalabrutinib in both unadjusted (hazard ratio [HR], 0.77 ;95% confidence interval [CI], 0.55–1.07), and base case adjusted (HR, 0.68; 95% CI, 0.46–0.99) populations
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Improved complete response for zanubrutinib versus acalabrutinib in the unadjusted (odds ratio [OR], 2.88; 95%CI, 1.18–7.02]) and base case adjusted populations (OR, 2.90; 95%CI, 1.13–7.43)
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A trend towards improved overall survival for zanubrutinib versus acalabrutinib
Overall, this comprehensive MAIC analysis demonstrated a PFS and CR advantage, and improved OS for zanubrutinib compared with acalabrutinib.
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