PMID- 37046657
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230415
IS  - 2072-6694 (Print)
IS  - 2072-6694 (Electronic)
IS  - 2072-6694 (Linking)
VI  - 15
IP  - 7
DP  - 2023 Mar 27
TI  - Efficacy and Safety of Bruton Tyrosine Kinase Inhibitor Monotherapy Compared with 
      Combination Therapy for Chronic Lymphocytic Leukemia and Small Lymphocytic 
      Lymphoma: A Systematic Review and Meta-Analysis.
LID - 10.3390/cancers15071996 [doi]
LID - 1996
AB  - The effectiveness and safety of combination treatments such as 
      chemoimmunotherapies in chronic lymphocytic leukemia and small lymphocytic 
      lymphoma (CLL/SLL) remain controversial. Bruton tyrosine kinase inhibitors 
      (BTKis) are an effective therapy for CLL/SLL patients. This meta-analysis aimed 
      to compare the efficacy and safety of BTKis versus combination therapy in CLL/SLL 
      patients. We searched the PubMed, Cochrane, Medline, and Embase databases through 
      February 2023 for relevant randomized controlled trials (RCTs). Four RCTs 
      (including 1510 patients) were found and met the inclusion criteria. 
      Progression-free survival (PFS) was significantly improved with BTKis when 
      compared to the combination therapy (hazard ratio (HR), 0.30; 95% confidence 
      interval (CI), 0.22-0.40), while a pooled analysis of overall survival did not 
      favor single-agent BTKis over the combination therapy (HR, 0.87; 95% CI, 
      0.67-1.15). We observed consistent benefits for PFS among patients with high-risk 
      disease characteristics. Although there was no difference in complete response 
      between the two arms (risk ratio (RR), 0.54; 95% CI, 0.20-1.46), BTKi use was 
      related to a better overall response rate (RR, 1.10; 95% CI, 1.04-1.16). The risk 
      of grade >/=3 adverse events (AEs) was comparable between the two arms (RR, 0.82; 
      95% CI, 0.55-1.23). However, the risk of grade >/=3 AEs was significantly lower in 
      the second-generation BTKi group than in the combination therapy group (RR, 0.73; 
      95% CI, 0.54-0.98). Overall, BTKis have superior efficacy compared to the 
      combination regimens in patients with untreated or treated CLL/SLL without excess 
      toxicity. Further studies are needed to confirm these results and determine the 
      optimal therapy for managing patients with CLL/SLL.
FAU - Nguyen, Thi Thuy
AU  - Nguyen TT
AUID- ORCID: 0000-0002-5050-574X
AD  - International Ph.D. Program in Medicine, College of Medicine, Taipei Medical 
      University, Taipei 110, Taiwan.
AD  - Department of Oncology, Hue University of Medicine and Pharmacy, Hue University, 
      Hue 49120, Vietnam.
FAU - Nhu, Nguyen Thanh
AU  - Nhu NT
AUID- ORCID: 0000-0002-1636-6061
AD  - International Ph.D. Program in Medicine, College of Medicine, Taipei Medical 
      University, Taipei 110, Taiwan.
AD  - Faculty of Medicine, Can Tho University of Medicine and Pharmacy, Can Tho 94117, 
      Vietnam.
FAU - Tran, Van Khoi
AU  - Tran VK
AD  - International Ph.D. Program in Medicine, College of Medicine, Taipei Medical 
      University, Taipei 110, Taiwan.
AD  - Department of Surgery, Hue University of Medicine and Pharmacy, Hue University, 
      Hue 49120, Vietnam.
FAU - Nguyen, Tran Thuc Huan
AU  - Nguyen TTH
AD  - Department of Oncology, Hue University of Medicine and Pharmacy, Hue University, 
      Hue 49120, Vietnam.
FAU - Lin, Chiou-Feng
AU  - Lin CF
AUID- ORCID: 0000-0003-4396-6086
AD  - Department of Microbiology and Immunology, School of Medicine, College of 
      Medicine, Taipei Medical University, Taipei 110, Taiwan.
AD  - Graduate Institute of Medical Sciences, College of Medicine, Taipei Medical 
      University, Taipei 110, Taiwan.
AD  - Core Laboratory of Immune Monitoring, Office of Research & Development, Taipei 
      Medical University, Taipei 110, Taiwan.
LA  - eng
GR  - MOST 110-2320-B-038-064-MY3/the Ministry of Science and Technology, Taiwan/
GR  - MOST 109-2320-B-038-050/Ministry of Science and Technology, Taiwan and the 
      Industry-University cooperation program A-111-101 from Taipei Medical University, 
      Taiwan/
PT  - Journal Article
PT  - Review
DEP - 20230327
PL  - Switzerland
TA  - Cancers (Basel)
JT  - Cancers
JID - 101526829
PMC - PMC10093473
OTO - NOTNLM
OT  - Bruton tyrosine kinase inhibitor
OT  - chronic lymphocytic leukemia
OT  - meta-analysis
OT  - small lymphocytic lymphoma
OT  - systematic review
COIS- The authors declare no conflict of interest.
EDAT- 2023/04/14 06:00
MHDA- 2023/04/14 06:01
PMCR- 2023/03/27
CRDT- 2023/04/13 01:07
PHST- 2023/02/22 00:00 [received]
PHST- 2023/03/23 00:00 [revised]
PHST- 2023/03/23 00:00 [accepted]
PHST- 2023/04/14 06:01 [medline]
PHST- 2023/04/13 01:07 [entrez]
PHST- 2023/04/14 06:00 [pubmed]
PHST- 2023/03/27 00:00 [pmc-release]
AID - cancers15071996 [pii]
AID - cancers-15-01996 [pii]
AID - 10.3390/cancers15071996 [doi]
PST - epublish
SO  - Cancers (Basel). 2023 Mar 27;15(7):1996. doi: 10.3390/cancers15071996.