Multinational phase 3 trial of zanubrutinib versus ibrutinib for relapsed or refractory CLL and SLL

Zanubrutinib is a potent, irreversible next-generation Bruton tyrosine kinase (BTK) inhibitor designed to maximize BTK occupancy and minimize off-target kinase inhibition. The multinational phase 3 ALPINE trial compared zanubrutinib versus the standard BTK-inhibitor ibrutinib for relapsed or refractory CLL or SLL. Zanubrutinib had a significantly higher ORR, lower atrial fibrillation rate, and improved progression-free survival and overall cardiac safety profile versus ibrutinib. The authors conclude that these data support improved efficacy/safety outcomes with selective BTK inhibition.