• Anna Puła, Konrad Stawiski, Marcin Braun, Elżbieta Iskierka-Jażdżewska, and Tadeusz Robak.
• a Department of Hematology , Medical University of Lodz, Copernicus Memorial Hospital , Lodz , Poland.
• Leuk. Lymphoma. 2018 May 1; 59 (5): 1084-1094.

AbstractIbrutinib and idelalisib, B-cell receptor (BCR) signaling pathway inhibitors, have been recently approved for use against relapsed/refractory chronic lymphocytic leukemia (CLL). To assess the efficacy and safety of BCR pathway inhibitors in relapsed/refractory CLL, we conducted a systematic review and meta-analysis of five randomized controlled trials (1866 patients). Our study demonstrated that BCR pathway inhibitors significantly prolonged progression-free survival (PFS; pooled HR = 0.24; 95% CI: 0.19-0.30) and overall survival (HR = 0.58; 0.46-0.73) compared with control treatment. BCR pathway inhibitors increased the probability of response (RR = 3.54; 95% CI: 1.69-7.41) and decreased the risk of progression (RR = 0.21, 95% CI: 0.13-0.34). However, BCR pathway inhibitors increased the risk of grade 3 and 4 adverse events (AEs; RR = 1.25; 95% CI: 1.08-1.44) and serious AEs (RR = 1.32; 95% CI: 1.17-1.50). AEs causing discontinuation (RR = 1.26; 95% CI: 0.88-1.81) or death (RR = 1.06; 95% CI: 0.72-1.57) were not significantly increased. No statistically significant difference in any aspect of meta-analysis was noted between ibrutinib and idelalisib.

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