Real-World Performance of China’s Anti-Cancer Drug Zanubrutinib in CLL/SLL Treatment: Efficacy and Safety

**Real-World Performance of China’s Anti-Cancer Drug Zanubrutinib in CLL/SLL Treatment: Efficacy and Safety**

CLL

#Ibrutinib #Zanubrutinib #CLL #SLL #BTKinhibitor #Oncology #cancerdrug #BTK #ASCO

With the advent of BTK inhibitors, the treatment paradigm for chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) has undergone a complete transformation, moving away from traditional chemotherapy. Zanubrutinib, a powerful BTK inhibitor developed independently by BeiGene in China, is a next-generation Bruton’s tyrosine kinase inhibitor (BTKi) that has demonstrated remarkable efficacy in clinical trials. A study presented at the 2024 ASCO conference sheds light on the real-world treatment patterns and outcomes of zanubrutinib, providing valuable insights for patients and clinicians.

### **Study Background**

Zanubrutinib, a fully China-developed anti-cancer drug, launched in late 2019, has been shown to be more effective than the first-generation BTKi, ibrutinib, in CLL/SLL patients. This retrospective study analyzed patients treated with zanubrutinib between 2018 and 2023 at Kaiser Permanente Northern California, focusing on treatment patterns, adverse events (AEs), and survival outcomes in a real-world setting.

### **Study Findings**

The study analyzed 281 patients with key findings as follows:

– **Patient Profile**: The median age of patients was 71 years, with 64% being male. Most patients were white (75%), followed by African Americans (10%). Of the total, 190 patients switched from ibrutinib to zanubrutinib, while 91 patients were treated solely with zanubrutinib.

– **Adverse Events**: Whether patients switched from ibrutinib or started directly on zanubrutinib, the latter showed significantly lower rates of cardiac toxicity and treatment-limiting adverse events (TLAEs). The most common AEs for zanubrutinib included cytopenia and rashes/bruising, while ibrutinib was more often associated with atrial fibrillation and fatigue.

– **Dose Adjustments and Treatment Continuity**: Some patients adjusted their doses due to mild AEs, but the majority (79%) were still receiving zanubrutinib at the end of the study. While 13 patients died, there were no treatment-related deaths.

### **Study Conclusion**

This study demonstrates that regardless of prior ibrutinib use, China’s homegrown anti-cancer drug, zanubrutinib, exhibited excellent efficacy and safety. Compared to ibrutinib, zanubrutinib had a lower incidence of cardiac toxicity and maintained its effectiveness even in older patients with more comorbidities. These real-world data reinforce zanubrutinib’s pivotal role in the treatment of CLL/SLL, further validating its clinical application.

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