Four-year follow-up of multinational phase 3 trial of first-line ibrutinib-venetoclax versus chlorambucil-obinutuzumab for CLL

The phase 3 GLOW trial, at 67 centers across 14 countries, randomized older or comorbid patients with previously untreated chronic lymphocytic leukemia (CLL) to the all-oral, once-daily, fixed-duration ibrutinib-venetoclax combination (n=106) or chlorambucil-obinutuzumab (n=105). After a median of 46 months (IQR 43-47) of follow-up, progression-free survival was superior for the ibrutinib-venetoclax group when compared to the chlorambucil-obinutuzumab group, both in the ITT population and in the IGHV-mutated population. Treatment-related deaths were reported for one patient in each group. The authors conclude that after four years of follow-up, ibrutinib-venetoclax significantly prolonged PFS versus chemoimmunotherapy in patients with previously untreated CLL, supporting its use as a first-line option.