Evidence map›Paper›PMID 36717653›Full record

Trial reportLeukemia2023

A phase 1b study of ibrutinib in combination with obinutuzumab in patients with relapsed or refractory chronic lymphocytic leukemia.

Christine E Ryan, Danielle M Brander, Paul M Barr, Svitlana Tyekucheva, Liam R Hackett, Mary C Collins, Stacey M Fernandes, Yue Ren, Yinglu Zhou, Mikaela M McDonough and 8 more

Abstract readRandomized Controlled TrialClinical Trial, Phase I
PubMed Publisher
In one paragraph

Trial report in Leukemia, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.2field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Pooled it
  2. Regulated cell death programs shaping cancer therapy.Cellular oncology (Dordrecht, Netherlands) · 2026
    Review
  3. Review
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

18 authors at 4 institutions in 1 country.

Christine E RyanDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0003-2588-1943
Danielle M BranderDivision of Hematologic Malignancies and Cellular Therapy, Duke Cancer Institute, Durham, NC, USA.
Paul M BarrWilmot Cancer Institute, University of Rochester Medical Center, Rochester, NY, USA.ORCID http://orcid.org/0000-0002-9733-401X
Svitlana TyekuchevaDepartment of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-3119-6507
Liam R HackettDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-3330-2369
Mary C CollinsDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Stacey M FernandesDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Yue RenDepartment of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.
Yinglu ZhouDepartment of Data Science, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0001-6276-635X
Mikaela M McDonoughDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Heather A WalkerDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0002-8015-4071
Monica R McEwanDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Jeremy S AbramsonCenter for Lymphoma, Massachusetts General Hospital, Boston, MA, USA.
Eric D JacobsenDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
Ann S LaCasceDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.
David C FisherDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0001-6915-8584
Jennifer R BrownDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA.ORCID http://orcid.org/0000-0003-2040-4961
Matthew S DavidsDepartment of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. Matthew_Davids@DFCI.Harvard.edu.ORCID http://orcid.org/0000-0003-4529-2003
Dana-Farber Cancer Institute · USDuke Medical Center · USMassachusetts General Hospital · USUniversity of Rochester Medical Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

This study investigated ibrutinib plus obinutuzumab in relapsed/refractory CLL, evaluating tolerability of 3 sequencing regimens as well as overall safety and efficacy. Fifty-two patients were initially randomized 1:1:1 to receive either obinutuzumab 1 month before ibrutinib initiation, ibrutinib 1 month prior to obinutuzumab initiation, or to start both drugs concomitantly. Higher rates of infusion-related reactions were observed with the first sequence, and only the latter 2 cohorts were expanded. Grade 4 hematologic toxicity was uncommon, and notable all-grade non-hematologic toxicities included bruising (58%), hypertension (46%), arthralgia (38%), diarrhea (37%), transaminitis (35%), atrial fibrillation (21%), and serious infection (17%). Best overall response rate was 96% (including 40% CR and 56% PR). Best rates of undetectable minimal residual disease in peripheral blood and bone marrow were 27% and 19%, respectively. With a median follow-up of 41.5 months, four-year progression-free and overall survival rates are 74% and 93%, respectively. Correlative studies demonstrated that serum CCL4 and CXCL13 levels were associated with clinical response, and BH3 profiling revealed increased BCL-2 and BCL-xL dependence in CLL cells from patients on treatment. Overall, ibrutinib plus obinutuzumab was highly active, with a manageable safety profile, supporting further investigation of this type of approach in relapsed/refractory CLL.

Indexed as

Leukemia, Lymphocytic, Chronic, B-CellAdenineAntibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsHumansPiperidinesRecurrenceAdenineAntibodies, Monoclonal, HumanizedibrutinibobinutuzumabPiperidines

Identifiers

PMID36717653
OpenAlexW4318480623

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.