Table 2. Comparison of key features of... | American Society of Hematology

Table 2.

Comparison of key features of frontline therapy for CLL

Treatment feature	VO	Ibrutinib	Standard chemoimmunotherapy regimens (FCR, BR, OChl)
Length of therapy	12 mo	Indefinite	6 mo
Route of administration	Oral (venetoclax) + IV (obinutuzumab)	Oral	IV (exception: chlorambucil = oral)
Notable side effects	TLS, cytopenias	Bleeding, atrial fibrillation, hypertension, arthralgias	Cytopenias, immunosuppression
Notable drug interactions	CYP3A4 inhibitors or inducers*	CYP3A4 inhibitors or inducers* Anticoagulants	N/A
Effects on immune system	Reduction in NK cells in mouse models²⁸	Reconstitution of humoral and cell-mediated immune system and reduction of macrophage phagocytosis^29-31	Suppression of the humoral and cell-mediated immune system
Longest median follow-up on clinical trials†	28 mo	∼60 mo	>70 mo

Treatment feature	VO	Ibrutinib	Standard chemoimmunotherapy regimens (FCR, BR, OChl)
Length of therapy	12 mo	Indefinite	6 mo
Route of administration	Oral (venetoclax) + IV (obinutuzumab)	Oral	IV (exception: chlorambucil = oral)
Notable side effects	TLS, cytopenias	Bleeding, atrial fibrillation, hypertension, arthralgias	Cytopenias, immunosuppression
Notable drug interactions	CYP3A4 inhibitors or inducers*	CYP3A4 inhibitors or inducers* Anticoagulants	N/A
Effects on immune system	Reduction in NK cells in mouse models²⁸	Reconstitution of humoral and cell-mediated immune system and reduction of macrophage phagocytosis^29-31	Suppression of the humoral and cell-mediated immune system
Longest median follow-up on clinical trials†	28 mo	∼60 mo	>70 mo

N/A, not applicable; OChl, obinutuzumab + chlorambucil.

Dose modifications may be required. Consultation with a pharmacist is recommended for thorough medication review.

Assessed August 2019.