Tislelizumab Plus Zanubrutinib Is an Effective Treatment for Patients with Richter Transformation

Tislelizumab plus zanubrutinib is an effective and well-tolerated treatment strategy for patients with chronic lymphocytic leukemia (CLL) with Richter transformation, according to a study published in Natural Medicine.

The phase II, international, prospective, open-label study was led by Othman Al-Sawaf, MD, of the Center for Integrated Oncology Aachen Bonn Köln Düsseldorf in Germany. A total of 59 patients with Richter transformation received the PD-1 inhibitor tislelizumab with the Bruton’s tyrosine kinase inhibitor zanubrutinib for 12 cycles and underwent maintenance treatment with both agents.

The primary endpoint was overall response rate (ORR) after six cycles, and the secondary endpoints were duration of response (DOR), progression-free survival (PFS), and overall survival (OS).

Of the 48 patients who received at least two cycles of treatment, 28 responded to induction therapy, with an ORR of 58.3%. The complete response rate was 18.8%, and the partial response rate was 39.6%. The median DOR was not reached, the median PFS was 10 months, and the 12-month OS rate was 74.7%.

Infections, gastrointestinal disorders, and hematological toxicities were the most common adverse events in this patient population.

Reference

Al-Sawaf O, Ligtvoet R, Robrecht S, et al. Tislelizumab plus zanubrutinib for Richter transformation: the phase 2 RT1 trial. Nat Med. 2023. doi:10.1038/s41591-023-02722-9