Acalabrutinib plus venetoclax with or without obinutuzumab versus chemoimmunotherapy for first-line treatment of CLL

Share :
Published: 18 Dec 2024
Views: 279
Rating:
Save
Dr Jennifer Brown - Dana-Farber Cancer Institute, Boston, USA

Dr Jennifer Brown speaks to ecancer about the results from the phase 3 AMPLIFY trial presented at ASH 2024. This trial evaluated fixed-duration acalabrutinib plus venetoclax with or without obinutuzumab versus chemoimmunotherapy for first-line treatment of chronic lymphocytic leukaemia (CLL)

She reports that the estimated BICR-assessed three year progression-free survival of acalabrutinib plus venetoclax was 76% compared with 66% for chemoimmunotherapy.

Dr Brown also highlights the progression-free survival of acalabrutinib plus venetoclax and obinutuzumab which was 83%.

The AMPLIFY trial is a phase III international study comparing acalabrutinib venetoclax with or without obinutuzumab to chemoimmunotherapy as a standard of care in previously untreated fit patients with chronic lymphocytic leukaemia. It’s designed as potentially a registration trial for the combination of the second-generation BTK inhibitor acalabrutinib with venetoclax which would be the first such regimen to become available.

What are the key results?

The primary endpoint was IRC-assessed progression free survival comparing acalabrutinib, venetoclax to chemoimmunotherapy. The study did meet this primary endpoint. The estimated 3-year progression free survival with AV was 76% compared to 66% for chemo. There was no planned comparison between the AV and the AV obinutuzumab arms but the first key secondary endpoint was the IRC-assessed progression free survival for the AVO regimen compared to chemoimmunotherapy and that was also met with an estimated 3-year progression free survival of 83% for AVO compared to 66% for chemoimmunotherapy. There was also evidence of improved or prolonged overall survival with AV compared to chemoimmunotherapy in the overall analysis.

What is the clinical significance of these results?

The AV regimen, in addition to being highly effective, was also very well tolerated. The serious adverse events were rare. The most common side effect was neutropenia but that was generally manageable and febrile neutropenia was rare. Cardiovascular events were also uncommon. It’s a 14-month regimen so it’s time-limited so there is less opportunity for cardiac events that we’ve seen with continuous administration.

The results are quite exciting because the AV regimen is something that we can give to most of our CLL patients pretty easily once it’s available. Then looking at the combination with obinutuzumab, that does add some toxicity, some more neutropenia and infections but it does also appear to deepen response and extend progression free survival. So that’s a good regimen for our fitter, younger patients for whom maximising progression free survival is important.

Of course, the overall, overarching benefit of the study is that it will hopefully lead to FDA, EMA and international approvals for acalabrutinib venetoclax with or without obinutuzumab as a front-line regimen for CLL patients. So it will become available as another option for our patients.

Related Videos

Epcoritamab plus rituximab and lenalidomide improves efficacy in relapsed or refractory follicular lymphoma

Dr Lorenzo Falchi - Memorial Sloan Kettering Cancer Center, New York, USA
Epcoritamab plus rituximab and lenalidomide improves efficacy in relapsed or refractory follicular lymphoma ( Dr Lorenzo Falchi - Memorial Sloan Kettering Cancer Center, New York, USA )
24 Feb 2026

Primary IVIG supplementation reduces the risk of high-grade infections in patients receiving teclistamab therapy for MM

Dr Heloise Cheruvalath - Medical College of Wisconsin, Milwaukee, USA
Primary IVIG supplementation reduces the risk of high-grade infections in patients receiving teclistamab therapy for MM ( Dr Heloise Cheruvalath - Medical College of Wisconsin, Milwaukee, USA )
18 Dec 2024

Glofitamab with rituximab, ifosfamide, carboplatin and etoposide shows favourable efficacy in RR diffuse large B-cell lymphoma

Dr Paolo Caimi - Cleveland Clinic, Cleveland, USA
Glofitamab with rituximab, ifosfamide, carboplatin  and etoposide shows favourable efficacy in RR diffuse large B-cell lymphoma ( Dr Paolo Caimi - Cleveland Clinic, Cleveland, USA )
18 Dec 2024

Pembrolizumab after chemo demonstrates promising activity in low-risk cHL

Prof Christine Mauz-Koerholz - Justus Liebig University, Giessen, Germany
Pembrolizumab after chemo demonstrates promising activity in low-risk cHL ( Prof Christine Mauz-Koerholz - Justus Liebig University, Giessen, Germany )
17 Dec 2024

Blinatumomab added to chemotherapy improves disease-free survival in newly diagnosed NCI standard risk paediatric B-ALL

Dr Rachel Rau - University of Washington, Seattle, USA
Blinatumomab added to chemotherapy improves disease-free survival in newly diagnosed NCI standard risk paediatric B-ALL ( Dr Rachel Rau - University of Washington, Seattle, USA )
16 Dec 2024

Demographics, characteristics, survival and outcomes in older, untreated, AML with NPM1 mutations or KMT2A rearrangements

Dr Ashley Yocum - Leukemia & Lymphoma Society, New York, USA
Demographics, characteristics, survival and outcomes in older, untreated, AML with NPM1 mutations or KMT2A rearrangements ( Dr Ashley Yocum - Leukemia & Lymphoma Society, New York, USA )
16 Dec 2024

Impact of MRD on progression-free survival in MM patients treated with isatuximab, lenalidomide, bortezomib and dexamethasone

Dr Elias Mai - University Hospital Heidelberg, Heidelberg, Germany
Impact of MRD on progression-free survival in MM patients treated with isatuximab, lenalidomide, bortezomib and dexamethasone ( Dr Elias Mai - University Hospital Heidelberg, Heidelberg, Germany )
16 Dec 2024

SIOG 2024: Updates in haematology

Dr Ashley Rosko - The Ohio State University, Columbus, USA
SIOG 2024: Updates in haematology ( Dr Ashley Rosko - The Ohio State University, Columbus, USA )
1 Nov 2024

Daratumumab-based maintenance regimens show favourable responses in transplant-eligible NDMM

Prof Meletios Dimopoulos - University of Athens, Athens, Greece
Daratumumab-based maintenance regimens show favourable responses in transplant-eligible NDMM ( Prof Meletios Dimopoulos - University of Athens,  Athens, Greece )
31 Oct 2024