Lancet: Acalabrutinib's first-line treatment of chronic lymphocytic leukemia is effective

Acalabrutinib is an alternative Bruton tyrosine kinase inhibitor that has the activity to treat chronic lymphocytic leukemiaThe researchers looked at the efficacy of Acalabrutinib in the treatment of patients with chronic lymphoblastic leukemia, either jointly or not with obinutuzumabELEVATE TN is a global, Phase III, multi-center, open-label study involving untreated patients with chronic lymphoblastic leukemia in 18 countriesEligible patients were treated randomly for acalabrutinib-binutuzumab, acalabrutinib monodrug or obinutuzumab-chlorambuci for a period of 28 daysThe main endpoint of the study was the progressionless survival rate535 patients participated in the study, of which 179 were treated with acalabrutinib-obinutuzumab, 179 were treated with acalabrutinib monodrug and 177 were treated with obinutuzumab-chloramilThe median follow-up was 28.3 months, compared to obinutuzumab-chlorambucil, and acalabuuzumab and acalabrutinib single-drug therapy had a progression-free median survival (both 22.6 months)Acalabrutinib-obinutuzumab, acalabrutinib monodrug therapy and obinutuzumab-chloroambumab had progression-free survival rates of 93%, 87% and 47% at 24 months, respectivelyThe most common level 3 or higher adverse events in each group were neutrophil decline (53 out of 178 cases in the acalabuib-obinutuzumab group, 17 out of 179 cases in the acalabrutinib group, and 70 cases in the 169 cases in the obinutuzumab-chlorombbuc groupAcalabrutinib-obinuturezumab (24 out of 178 patients) had a less than a full-stage infusion response compared to obinutuzumab-chlorambucil (67 out of 169 patients)37 (21%) patients treated with acalabrutinib-obinutuzumab, 25 (14%) patients treated with acarutinib monodrug, and 14 (8%) patients treated with obinutuzumab-chlorambucil had a level 3 or higher infectionEight (4%) patients taking acalabrutinib-obinutuzumab, 12 (7%) patients taking acalabrutinib, and 15 (9%) patients taking obinutuzumab-chlorambucil diedstudies have shown that Acalabrutinib combined or non-combined obinutuzumab significantly improved the progression survival rate of patients with chronic lymphocytic leukemia, and its effect was better than opnutuzumab-chlorambucil chemotherapy immunotherapy, which can be used as the preferred treatment for chronic lymphocytic leukemia