Idelalisib plus rituximab versus ibrutinib in the treatment of relapsed/refractory chronic lymphocytic leukaemia: A real‐world analysis from the Chronic Lymphocytic Leukemia Patients Registry (CLLEAR)

• DOI: 10.1111/bjh.18736
• Publication Date: 2023-03-27T09:15:56Z
• Authors: Martin Špaček; Lukáš Smolej; Martin Šimkovič; Lucie Nekvindová; Zlatuše Křístková; Yvona Brychtová; Anna Panovská; Stanislava Mašlejová; Lucie Bezděková; Dominika Écsiová; Pavel Vodárek; Jana Zuchnická; Jana Mihályová; Renata Urbanová; Peter Turcsányi; Daniel Lysák; Jan Novák; Martin Brejcha; Tereza Líkařová; Prokop Vodička; Jana Baranová; Marek Trněný; Michael Doubek
• Keywords: Idelalisib; Ofatumumab; Discontinuation; Tolerability

Summary Idelalisib (idela), a phosphatidylinositol 3‐kinase inhibitor, and ibrutinib, Bruton tyrosine kinase were the first oral targeted agents approved for relapsed/refractory (R/R) chronic lymphocytic leukaemia (CLL). However, no randomised trials of idelalisib plus rituximab (R‐idela) versus ibrutinib have been conducted. Therefore, we performed real‐world retrospective analysis patients with R/R CLL treated R‐idela ( n = 171) or 244). The median age was 70 69 years, two previous lines. There trend towards higher tumour protein p53 TP53 ) aberrations complex karyotype in group (53% vs. 44%, p 0.093; 57% 46%, 0.083). progression‐free survival (PFS) significantly longer (40.5 22.0 months; < 0.001); similarly to overall (OS; 54.4 37.7 months, 0.04). In multivariate analysis, only PFS but not OS remained different between agents. most common reasons treatment discontinuation included toxicity (R‐idela, 39.8%; 22.5%) progression (27.5% 11.1%). conclusion, our data show better efficacy tolerability over routine practice. regimen may still be considered reasonable option highly selected without suitable alternative.