A large real-world study found that zanubrutinib (Brukinsa) was associated with better outcomes than acalabrutinib (Calquence) in patients with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).
Researchers analyzed insurance claims data from nearly 16,800 patients, including 5,819 treated with zanubrutinib and 10,969 treated with acalabrutinib. Patient characteristics were similar between the two groups.
After adjusting for baseline differences, zanubrutinib reduced the risk of needing a subsequent treatment by 11% and lowered the risk of death by 25% compared with acalabrutinib. At 30 months, 84% of patients receiving zanubrutinib had not required another treatment versus 80% of those receiving acalabrutinib. Overall survival at 30 months was 91% with zanubrutinib and 89% with acalabrutinib.
The investigators noted several limitations, including differences in follow-up time, potential inaccuracies in claims data, and the lack of important genetic information such as TP53 and IGHV status, which could influence outcomes. Despite these limitations, the findings suggest zanubrutinib may offer an advantage as a first-line BTK inhibitor for CLL and SLL.