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Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia

Identifieur interne : 000304 ( PascalFrancis/Corpus ); précédent : 000303; suivant : 000305

Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia

Auteurs : J. C. Byrd ; J. R. Brown ; S. O'Brien ; J. C. Barrientos ; N. E. Kay ; N. M. Reddy ; S. Coutre ; C. S. Tam ; S. P. Mulligan ; U. Jaeger ; S. Devereux ; P. M. Barr ; R. R. Furman ; T. J. Kipps ; F. Cymbalista ; C. Pocock ; P. Thornton ; F. Caligaris-Cappio ; T. Robak ; J. Delgado ; S. J. Schuster ; M. Montillo ; A. Schuh ; S. De Vos ; D. Gill ; A. Bloor ; C. Dearden ; C. Moreno ; J. J. Jones ; A. D. Chu ; M. Fardis ; J. Mcgreivy ; F. Clow ; D. F. James ; P. Hillmen

Source :

RBID : Pascal:14-0198874

Descripteurs français

English descriptors

Abstract

BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A01 01  1    @0 0028-4793
A02 01      @0 NEJMAG
A03   1    @0 N. Engl. j. med.
A05       @2 371
A06       @2 3
A08 01  1  ENG  @1 Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia
A11 01  1    @1 BYRD (J. C.)
A11 02  1    @1 BROWN (J. R.)
A11 03  1    @1 O'BRIEN (S.)
A11 04  1    @1 BARRIENTOS (J. C.)
A11 05  1    @1 KAY (N. E.)
A11 06  1    @1 REDDY (N. M.)
A11 07  1    @1 COUTRE (S.)
A11 08  1    @1 TAM (C. S.)
A11 09  1    @1 MULLIGAN (S. P.)
A11 10  1    @1 JAEGER (U.)
A11 11  1    @1 DEVEREUX (S.)
A11 12  1    @1 BARR (P. M.)
A11 13  1    @1 FURMAN (R. R.)
A11 14  1    @1 KIPPS (T. J.)
A11 15  1    @1 CYMBALISTA (F.)
A11 16  1    @1 POCOCK (C.)
A11 17  1    @1 THORNTON (P.)
A11 18  1    @1 CALIGARIS-CAPPIO (F.)
A11 19  1    @1 ROBAK (T.)
A11 20  1    @1 DELGADO (J.)
A11 21  1    @1 SCHUSTER (S. J.)
A11 22  1    @1 MONTILLO (M.)
A11 23  1    @1 SCHUH (A.)
A11 24  1    @1 DE VOS (S.)
A11 25  1    @1 GILL (D.)
A11 26  1    @1 BLOOR (A.)
A11 27  1    @1 DEARDEN (C.)
A11 28  1    @1 MORENO (C.)
A11 29  1    @1 JONES (J. J.)
A11 30  1    @1 CHU (A. D.)
A11 31  1    @1 FARDIS (M.)
A11 32  1    @1 MCGREIVY (J.)
A11 33  1    @1 CLOW (F.)
A11 34  1    @1 JAMES (D. F.)
A11 35  1    @1 HILLMEN (P.)
A14 01      @1 Ohio State University Comprehensive Cancer Center @2 Columbus, New York @3 USA @Z 1 aut. @Z 29 aut.
A14 02      @1 Dana-Farber Cancer Institute @2 Boston, New York @3 USA @Z 2 aut.
A14 03      @1 M.D. Anderson Cancer Center @2 Houston, New York @3 USA @Z 3 aut.
A14 04      @1 Hofstra North Shore-LIJ School of Medicine @2 Hempstead, New York @3 USA @Z 4 aut.
A14 05      @1 University of Rochester Cancer Center @2 Rochester, New York @3 USA @Z 12 aut.
A14 06      @1 New York-Presbyterian Hospital and Weill Cornell Medical College @2 New York, New York @3 USA @Z 13 aut.
A14 07      @1 Mayo Clinic, Rochester @2 MN, California @3 USA @Z 5 aut.
A14 08      @1 Vanderbilt-Ingram Cancer Center @2 Nashville, California @3 USA @Z 6 aut.
A14 09      @1 Stanford University School of Medicine and Stanford Cancer Institute @2 Stanford, California @3 USA @Z 7 aut.
A14 10      @1 Moores UCSD Cancer Center @2 San Diego, California @3 USA @Z 14 aut.
A14 11      @1 David Geffen School of Medicine at UCLA @2 Los Angeles, California @3 USA @Z 24 aut.
A14 12      @1 Pharmacyclics @2 Sunnyvale, California @3 USA @Z 15 aut. @Z 30 aut. @Z 31 aut. @Z 32 aut. @Z 34 aut.
A14 13      @1 Peter MacCallum Cancer Centre and St. Vincent's Hospital @2 Melbourne, VIC @3 AUS @Z 8 aut.
A14 14      @1 Royal North Shore Hospital @2 Sydney, NSW @3 AUS @Z 9 aut.
A14 15      @1 Princess Alexandra Hospital @2 Brisbane, QLD @3 AUS @Z 25 aut.
A14 16      @1 Medical University of Vienna @2 Vienna @3 AUT @Z 10 aut.
A14 17      @1 Kings College Hospital, National Health Service (NHS) Foundation Trust Denmark Hill @2 London @3 GBR @Z 11 aut.
A14 18      @1 East Kent Hospitals @2 Canterbury @3 GBR @Z 16 aut.
A14 19      @1 Oxford Biomedical Research Centre @2 Oxford @3 GBR @Z 23 aut.
A14 20      @1 Christie NHS Foundation Trust Hematology and Transplant Unit @2 Manchester @3 GBR @Z 26 aut.
A14 21      @1 Royal Marsden Hospital and the Institute of Cancer Research @2 Sutton @3 GBR @Z 27 aut.
A14 22      @1 Leeds Teaching Hospitals, St. James Institute of Oncology @2 Leeds @3 GBR @Z 35 aut.
A14 23      @1 Hôpital Avicenne @2 Paris @3 FRA @Z 33 aut.
A14 24      @1 Beaumont Hospital @2 Dublin @3 IRL @Z 17 aut.
A14 25      @1 Universita Vita-Salute San Raffaele @2 Milan @3 ITA @Z 18 aut.
A17 01  1    @1 RESONATE Investigators @3 INC
A20       @1 213-223
A21       @1 2014
A23 01      @0 ENG
A43 01      @1 INIST @2 6013 @5 354000504822650050
A44       @0 0000 @1 © 2014 INIST-CNRS. All rights reserved.
A45       @0 28 ref.
A47 01  1    @0 14-0198874
A60       @1 P
A61       @0 A
A64 01  1    @0 The New England journal of medicine
A66 01      @0 USA
C01 01    ENG  @0 BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.
C02 01  X    @0 002B01
C02 02  X    @0 002B19B
C03 01  X  FRE  @0 Leucémie @5 01
C03 01  X  ENG  @0 Leukemia @5 01
C03 01  X  SPA  @0 Leucemia @5 01
C03 02  X  FRE  @0 Ofatumumab @2 FR @5 04
C03 02  X  ENG  @0 Ofatumumab @2 FR @5 04
C03 02  X  SPA  @0 Ofatumumab @2 FR @5 04
C03 03  X  FRE  @0 Etude comparative @5 07
C03 03  X  ENG  @0 Comparative study @5 07
C03 03  X  SPA  @0 Estudio comparativo @5 07
C03 04  X  FRE  @0 Traitement @5 08
C03 04  X  ENG  @0 Treatment @5 08
C03 04  X  SPA  @0 Tratamiento @5 08
C03 05  X  FRE  @0 Chronique @5 09
C03 05  X  ENG  @0 Chronic @5 09
C03 05  X  SPA  @0 Crónico @5 09
C03 06  X  FRE  @0 Médecine @5 13
C03 06  X  ENG  @0 Medicine @5 13
C03 06  X  SPA  @0 Medicina @5 13
C03 07  X  FRE  @0 Anticancéreux @5 30
C03 07  X  ENG  @0 Antineoplastic agent @5 30
C03 07  X  SPA  @0 Anticanceroso @5 30
C07 01  X  FRE  @0 Anticorps monoclonal @5 37
C07 01  X  ENG  @0 Monoclonal antibody @5 37
C07 01  X  SPA  @0 Anticuerpo monoclonal @5 37
C07 02  X  FRE  @0 Hémopathie maligne @2 NM @5 38
C07 02  X  ENG  @0 Malignant hemopathy @2 NM @5 38
C07 02  X  SPA  @0 Hemopatía maligna @2 NM @5 38
C07 03  X  FRE  @0 Cancer @2 NM
C07 03  X  ENG  @0 Cancer @2 NM
C07 03  X  SPA  @0 Cáncer @2 NM
C07 04  X  FRE  @0 Antigène CD20 @4 INC @5 86
C07 05  X  FRE  @0 Anti-CD20 @4 INC @5 87
N21       @1 244
N44 01      @1 OTO
N82       @1 OTO

Format Inist (serveur)

NO : PASCAL 14-0198874 INIST
ET : Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia
AU : BYRD (J. C.); BROWN (J. R.); O'BRIEN (S.); BARRIENTOS (J. C.); KAY (N. E.); REDDY (N. M.); COUTRE (S.); TAM (C. S.); MULLIGAN (S. P.); JAEGER (U.); DEVEREUX (S.); BARR (P. M.); FURMAN (R. R.); KIPPS (T. J.); CYMBALISTA (F.); POCOCK (C.); THORNTON (P.); CALIGARIS-CAPPIO (F.); ROBAK (T.); DELGADO (J.); SCHUSTER (S. J.); MONTILLO (M.); SCHUH (A.); DE VOS (S.); GILL (D.); BLOOR (A.); DEARDEN (C.); MORENO (C.); JONES (J. J.); CHU (A. D.); FARDIS (M.); MCGREIVY (J.); CLOW (F.); JAMES (D. F.); HILLMEN (P.)
AF : Ohio State University Comprehensive Cancer Center/Columbus, New York/Etats-Unis (1 aut., 29 aut.); Dana-Farber Cancer Institute/Boston, New York/Etats-Unis (2 aut.); M.D. Anderson Cancer Center/Houston, New York/Etats-Unis (3 aut.); Hofstra North Shore-LIJ School of Medicine/Hempstead, New York/Etats-Unis (4 aut.); University of Rochester Cancer Center/Rochester, New York/Etats-Unis (12 aut.); New York-Presbyterian Hospital and Weill Cornell Medical College/New York, New York/Etats-Unis (13 aut.); Mayo Clinic, Rochester/MN, California/Etats-Unis (5 aut.); Vanderbilt-Ingram Cancer Center/Nashville, California/Etats-Unis (6 aut.); Stanford University School of Medicine and Stanford Cancer Institute/Stanford, California/Etats-Unis (7 aut.); Moores UCSD Cancer Center/San Diego, California/Etats-Unis (14 aut.); David Geffen School of Medicine at UCLA/Los Angeles, California/Etats-Unis (24 aut.); Pharmacyclics/Sunnyvale, California/Etats-Unis (15 aut., 30 aut., 31 aut., 32 aut., 34 aut.); Peter MacCallum Cancer Centre and St. Vincent's Hospital/Melbourne, VIC/Australie (8 aut.); Royal North Shore Hospital/Sydney, NSW/Australie (9 aut.); Princess Alexandra Hospital/Brisbane, QLD/Australie (25 aut.); Medical University of Vienna/Vienna/Autriche (10 aut.); Kings College Hospital, National Health Service (NHS) Foundation Trust Denmark Hill/London/Royaume-Uni (11 aut.); East Kent Hospitals/Canterbury/Royaume-Uni (16 aut.); Oxford Biomedical Research Centre/Oxford/Royaume-Uni (23 aut.); Christie NHS Foundation Trust Hematology and Transplant Unit/Manchester/Royaume-Uni (26 aut.); Royal Marsden Hospital and the Institute of Cancer Research/Sutton/Royaume-Uni (27 aut.); Leeds Teaching Hospitals, St. James Institute of Oncology/Leeds/Royaume-Uni (35 aut.); Hôpital Avicenne/Paris/France (33 aut.); Beaumont Hospital/Dublin/Irlande (17 aut.); Universita Vita-Salute San Raffaele/Milan/Italie (18 aut.)
DT : Publication en série; Niveau analytique
SO : The New England journal of medicine; ISSN 0028-4793; Coden NEJMAG; Etats-Unis; Da. 2014; Vol. 371; No. 3; Pp. 213-223; Bibl. 28 ref.
LA : Anglais
EA : BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.
CC : 002B01; 002B19B
FD : Leucémie; Ofatumumab; Etude comparative; Traitement; Chronique; Médecine; Anticancéreux
FG : Anticorps monoclonal; Hémopathie maligne; Cancer; Antigène CD20; Anti-CD20
ED : Leukemia; Ofatumumab; Comparative study; Treatment; Chronic; Medicine; Antineoplastic agent
EG : Monoclonal antibody; Malignant hemopathy; Cancer
SD : Leucemia; Ofatumumab; Estudio comparativo; Tratamiento; Crónico; Medicina; Anticanceroso
LO : INIST-6013.354000504822650050
ID : 14-0198874

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<div type="abstract" xml:lang="en">BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.</div>
</front>
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<s0>14-0198874</s0>
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<s0>BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.</s0>
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<NO>PASCAL 14-0198874 INIST</NO>
<ET>Ibrutinib versus Ofatumumab in Previously Treated Chronic Lymphoid Leukemia</ET>
<AU>BYRD (J. C.); BROWN (J. R.); O'BRIEN (S.); BARRIENTOS (J. C.); KAY (N. E.); REDDY (N. M.); COUTRE (S.); TAM (C. S.); MULLIGAN (S. P.); JAEGER (U.); DEVEREUX (S.); BARR (P. M.); FURMAN (R. R.); KIPPS (T. J.); CYMBALISTA (F.); POCOCK (C.); THORNTON (P.); CALIGARIS-CAPPIO (F.); ROBAK (T.); DELGADO (J.); SCHUSTER (S. J.); MONTILLO (M.); SCHUH (A.); DE VOS (S.); GILL (D.); BLOOR (A.); DEARDEN (C.); MORENO (C.); JONES (J. J.); CHU (A. D.); FARDIS (M.); MCGREIVY (J.); CLOW (F.); JAMES (D. F.); HILLMEN (P.)</AU>
<AF>Ohio State University Comprehensive Cancer Center/Columbus, New York/Etats-Unis (1 aut., 29 aut.); Dana-Farber Cancer Institute/Boston, New York/Etats-Unis (2 aut.); M.D. Anderson Cancer Center/Houston, New York/Etats-Unis (3 aut.); Hofstra North Shore-LIJ School of Medicine/Hempstead, New York/Etats-Unis (4 aut.); University of Rochester Cancer Center/Rochester, New York/Etats-Unis (12 aut.); New York-Presbyterian Hospital and Weill Cornell Medical College/New York, New York/Etats-Unis (13 aut.); Mayo Clinic, Rochester/MN, California/Etats-Unis (5 aut.); Vanderbilt-Ingram Cancer Center/Nashville, California/Etats-Unis (6 aut.); Stanford University School of Medicine and Stanford Cancer Institute/Stanford, California/Etats-Unis (7 aut.); Moores UCSD Cancer Center/San Diego, California/Etats-Unis (14 aut.); David Geffen School of Medicine at UCLA/Los Angeles, California/Etats-Unis (24 aut.); Pharmacyclics/Sunnyvale, California/Etats-Unis (15 aut., 30 aut., 31 aut., 32 aut., 34 aut.); Peter MacCallum Cancer Centre and St. Vincent's Hospital/Melbourne, VIC/Australie (8 aut.); Royal North Shore Hospital/Sydney, NSW/Australie (9 aut.); Princess Alexandra Hospital/Brisbane, QLD/Australie (25 aut.); Medical University of Vienna/Vienna/Autriche (10 aut.); Kings College Hospital, National Health Service (NHS) Foundation Trust Denmark Hill/London/Royaume-Uni (11 aut.); East Kent Hospitals/Canterbury/Royaume-Uni (16 aut.); Oxford Biomedical Research Centre/Oxford/Royaume-Uni (23 aut.); Christie NHS Foundation Trust Hematology and Transplant Unit/Manchester/Royaume-Uni (26 aut.); Royal Marsden Hospital and the Institute of Cancer Research/Sutton/Royaume-Uni (27 aut.); Leeds Teaching Hospitals, St. James Institute of Oncology/Leeds/Royaume-Uni (35 aut.); Hôpital Avicenne/Paris/France (33 aut.); Beaumont Hospital/Dublin/Irlande (17 aut.); Universita Vita-Salute San Raffaele/Milan/Italie (18 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>The New England journal of medicine; ISSN 0028-4793; Coden NEJMAG; Etats-Unis; Da. 2014; Vol. 371; No. 3; Pp. 213-223; Bibl. 28 ref.</SO>
<LA>Anglais</LA>
<EA>BACKGROUND In patients with chronic lymphoid leukemia (CLL) or small lymphocytic lymphoma (SLL), a short duration of response to therapy or adverse cytogenetic abnormalities are associated with a poor outcome. We evaluated the efficacy of ibrutinib, a covalent inhibitor of Bruton's tyrosine kinase, in patients at risk for a poor outcome. METHODS In this multicenter, open-label, phase 3 study, we randomly assigned 391 patients with relapsed or refractory CLL or SLL to receive daily ibrutinib or the anti-CD20 antibody ofatumumab. The primary end point was the duration of progression-free survival, with the duration of overall survival and the overall response rate as secondary end points. RESULTS At a median follow-up of 9.4 months, ibrutinib significantly improved progression-free survival; the median duration was not reached in the ibrutinib group (with a rate of progression-free survival of 88% at 6 months), as compared with a median of 8.1 months in the ofatumumab group (hazard ratio for progression or death in the ibrutinib group, 0.22; P<0.001). Ibrutinib also significantly improved overall survival (hazard ratio for death, 0.43; P=0.005). At 12 months, the overall survival rate was 90% in the ibrutinib group and 81% in the ofatumumab group. The overall response rate was significantly higher in the ibrutinib group than in the ofatumumab group (42.6% vs. 4.1%, P<0.001). An additional 20% of ibrutinib-treated patients had a partial response with lymphocytosis. Similar effects were observed regardless of whether patients had a chromosome 17p13.1 deletion or resistance to purine analogues. The most frequent nonhematologic adverse events were diarrhea, fatigue, pyrexia, and nausea in the ibrutinib group and fatigue, infusion-related reactions, and cough in the ofatumumab group. CONCLUSIONS Ibrutinib, as compared with ofatumumab, significantly improved progression-free survival, overall survival, and response rate among patients with previously treated CLL or SLL.</EA>
<CC>002B01; 002B19B</CC>
<FD>Leucémie; Ofatumumab; Etude comparative; Traitement; Chronique; Médecine; Anticancéreux</FD>
<FG>Anticorps monoclonal; Hémopathie maligne; Cancer; Antigène CD20; Anti-CD20</FG>
<ED>Leukemia; Ofatumumab; Comparative study; Treatment; Chronic; Medicine; Antineoplastic agent</ED>
<EG>Monoclonal antibody; Malignant hemopathy; Cancer</EG>
<SD>Leucemia; Ofatumumab; Estudio comparativo; Tratamiento; Crónico; Medicina; Anticanceroso</SD>
<LO>INIST-6013.354000504822650050</LO>
<ID>14-0198874</ID>
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