Efficacy and safety of ofatumumab versus ibrutinib in patients with refractory chronic lymphocytic leukemia: a systematic review

Abstract

Introduction: Chronic Lymphoid Leukemia (CLL) is characterized by a heterogeneous natural history despite being partially predicted by clinical and genomic characteristics. LLC therapy has evolved from monotherapy with alkylating agents to chemoimmunotherapy, where each combination regimen has shown prolonged progression-free survival rates in studies compared to similar regimens that do not contain antibodies. Methods: A systematic review of studies published in the literature that evaluated the efficacy and safety of ofatumumab versus ibrutinib was performed. Search platforms were searched, including Pubmed (Medline), Cochrane and EMBASE, with various combinations of terms, as well as manual searches. Methodological quality was assessed using the Cochrane tool. Results: Of the 344 publications, 3 were finally included and report results from a single randomized clinical trial. The results demonstrate that among patients with recurrent CLL or SLL, including those who had a short duration of response to previous therapy or who had adverse cytogenetic abnormalities, ibrutinib was superior to ofatumumab in relation to SLP, SG and average response rate despite having more serious adverse events. Conclusion: ibrutinib, compared to ofatumumab, significantly improved progression-free survival, overall survival and response rate among previously treated CLL or SLL patients. In terms of safety, more serious adverse effects have been reported with ibrutinib and therefore caution is needed when making a decision regarding use due to a lack of more robust evidence to support the possible benefits