4CPS-098 Indirect treatment comparisons of ibrutinib–obinotuzumab versus venetoclax–obinotuzumab in naive chronic lymphocytic leukaemia

Background and importance Venetoclax and ibrutinib are relatively new drugs and are currently elective treatments according to the guidelines for patients diagnosed with high risk chronic lymphocytic leukaemia (CLL). Aim and objectives To conduct an indirect comparison of the efficacy of venetoclax (12 cycles)+obinotuzumab (6 cycles) compared with ibrutinib (until progression)+obinotuzumab (6 cycles) and its costs. Material and methods The clinical trials CLL14 and ILUMINATE were reviewed, and the main outcome and similarity of the population (median age, percentage of high risk patients according to the Binet or Rai classification and percentage of patients with high risk cytogenetics) were evaluated. An indirect comparison of median progression free survival (PFS), PFS at 24 months, minimal residual disease (MRD) in peripheral blood, overall survival (OS) and complete response was conducted. Lastly, the cost of both 12 and 24 months of treatment were compared. Conclusion and relevance Although in advance, populations could be comparable, limitations such as time of treatment with chlorambucil exist (6 months vs 12 months). No statistically significant differences were found between: o Median PFS and 24 month PFS: Beauchemin et al1 concluded that correlations between PFS and OS exist in patients previously treated, but not in naive patients. o MDR and CR: Langerat et al2 concluded that “MRD status is associated with PFS and OS in CLL patients, and has the potential to act as a surrogate marker”. Ibrutinib cost was superior after the first year of treatment. To conclude, it is necessary to obtain OS data to conduct an indirect comparison of greater quality. References and/or acknowledgements 1. DOI: 10.1182/blood-2018-03-839688 2. DOI: 10.3747/co.22.2119. No conflict of interest.