PMID- 37843620
OWN - NLM
STAT- Publisher
LR  - 20231016
IS  - 1432-0584 (Electronic)
IS  - 0939-5555 (Linking)
DP  - 2023 Oct 16
TI  - Efficacy and safety of new-generation Bruton tyrosine kinase inhibitors in 
      chronic lymphocytic leukemia/small lymphocytic lymphoma: a systematic review and 
      meta-analysis.
LID - 10.1007/s00277-023-05486-x [doi]
AB  - Chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL) is a type of 
      mature B lymphocyte clonal proliferative tumor with a specific immunophenotype. 
      Bruton tyrosine kinase inhibitors (BTKi) have been approved for the treatment of 
      CLL/SLL. However, the efficacy and safety of new-generation BTKi-based regimens 
      have not been systematically studied. In this systematic review, we evaluated the 
      efficacy and safety of new-generation BTKi-based regimens for the treatment of 
      patients with CLL/SLL. A comprehensive search on PubMed, Embase, Cochrane 
      Library, and ClinicalTrials.gov. up to January 31, 2023, was conducted by us. 
      Studies reporting data on CLL/SLL patients treated with new-generation BTKi were 
      included. We assessed the overall response rate (ORR), complete response (CR) 
      rate, and 24-month OS/PFS rates for efficacy analysis. For safety analysis, we 
      evaluated the incidence of grade >/= 3 adverse events (AEs). The meta-analysis 
      included twenty studies. The pooled ORR for new-generation BTKi was 92% (95% CI, 
      89-95%, I(2) = 80.68%, P = 0.00), while the pooled CR rate was 10% (95% CI, 
      6-14%, I(2) = 88.11%, P = 0.00). Research has found that the new-generation 
      BTKi-based therapy had higher efficacy under the following treatment 
      conditions: < 65 years old, treatment-naive (TN)-CLL, and BTKi combination 
      therapy. The ORR/CR rates and 24-month OS/PFS rates of BTKi combination therapy 
      were higher than that of BTKi monotherapy. Compared to acalabrutinib monotherapy, 
      zanubrutinib monotherapy demonstrated higher ORR/CR rates and 24-month OS/PFS 
      rates. Common grade >/= 3 AEs included cytopenia and hypertension. The 
      new-generation BTKi-based therapy has good tolerance and provides incremental 
      benefits for CLL/SLL patients. Despite the superior efficacy of BTKi combination 
      therapy compared to monotherapy, its AEs rates are relatively high. Compared to 
      acalabrutinib, Zanubrutinib may be the preferred monotherapy for CLL. However, 
      randomized-controlled studies are still needed.
CI  - (c) 2023. The Author(s).
FAU - Yin, Shuo
AU  - Yin S
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China.
FAU - Zheng, Xiaohong
AU  - Zheng X
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China.
FAU - Zhang, Weichunbai
AU  - Zhang W
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China.
FAU - Zhao, Hanyun
AU  - Zhao H
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China.
FAU - Zhang, Rong
AU  - Zhang R
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China.
FAU - Li, Wenbin
AU  - Li W
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China. liwenbin@ccmu.edu.cn.
FAU - Chen, Feng
AU  - Chen F
AD  - Department of Neuro-Oncology, Cancer Center, Beijing Tiantan Hospital, Capital 
      Medical University, Beijing, 100070, China. chenfeng@bjtth.org.
LA  - eng
PT  - Journal Article
PT  - Review
DEP - 20231016
PL  - Germany
TA  - Ann Hematol
JT  - Annals of hematology
JID - 9107334
SB  - IM
OTO - NOTNLM
OT  - Bruton tyrosine kinase inhibitor
OT  - Chronic lymphocytic leukemia
OT  - Meta-analysis
OT  - Small lymphocytic lymphoma
OT  - Systematic review
EDAT- 2023/10/16 12:43
MHDA- 2023/10/16 12:43
CRDT- 2023/10/16 11:06
PHST- 2023/07/08 00:00 [received]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/10/16 12:43 [medline]
PHST- 2023/10/16 12:43 [pubmed]
PHST- 2023/10/16 11:06 [entrez]
AID - 10.1007/s00277-023-05486-x [pii]
AID - 10.1007/s00277-023-05486-x [doi]
PST - aheadofprint
SO  - Ann Hematol. 2023 Oct 16. doi: 10.1007/s00277-023-05486-x.