ASCO 2025 | Five-year follow-up of SEQUOIA Arm C: zanubrutinib in patients with del(17p) CLL

So the study today is really about the long-term results of zanubrutinib in patients with 17p deletion CLL. So prior to this, 17p deletion CLL is a horrible disease to treat with very poor treatment outcomes, and there are smaller studies with acalabrutinib and ibrutinib to suggest that these patients do well in the medium term. So what we have in the arm c of the SEQUOIA study is actually the largest collection of patients with 17p disease treated uniformly with a single drug, which is zanubrutinib. So this is 110 patients in total. They all have 17p. They all received zanubrutinib and we now have five years’ follow-up from those patients. So the key result is that we have a five-year progression-free survival of 72.2%. Now, to put this in context, if you compare this against the other arm in SEQUOIA, where patients without 17p were treated with zanubrutinib, that progression-free survival is 75%. So really, 75% without 17p, 72% with 17p, I think what that largely shows is that zanubrutinib is able to neutralize the very adverse risk of this previously very hard to treat disease. So I think there’s an immediate practice application to this and that is that if you have a patient with 17p deletion CLL and you need to treat them, that the best information and the best data is with zanubrutinib at this point in time. The future directions are how to use zanubrutinib or similar BTK inhibitors in limited duration therapies to further improve the outcome of 17p disease without having the patients take drugs long term. So we are doing those studies where patients are being given combinations of zanubrutinib and a BCL2 inhibitor in limited duration. And we’re hoping to achieve equally as good results, if not better, without having to subject patients to long-term treatment.

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