A new study has shown promising results for a triple therapy approach in treating relapsed/refractory chronic lymphocytic leukemia (CLL). The phase II CLL2-BAAG trial evaluated the efficacy of a measurable residual disease (MRD)-guided treatment regimen consisting of acalabrutinib, venetoclax, and obinutuzumab in 45 patients with CLL.
MRD, which was assessed using flow cytometry in peripheral blood and ctDNA examined by PCR, reached an undetectable level in 75.6% of patients after 6 months of triple therapy. This rate increased to 93.3% during a median follow-up of 36.3 months and even reached 94.4% among patients with TP53 mutations. Importantly, the 3-year progression-free survival and overall survival rates were 85.0% and 93.8%, respectively.
Only 5 out of 18 MRD occurrences identified resulted in clinical progression, highlighting the effectiveness of the MRD-guided therapy. These findings suggest that MRD-guided therapy could be a robust treatment approach for CLL and advocate for the integration of ctDNA assessment into routine clinical practice.
The results of this study, published in BioPress, offer hope for patients with relapsed/refractory CLL and may pave the way for more personalized and effective treatment strategies in the future.