ASH 2023: ALPINE Study Updates - Zanubrutinib vs Ibrutinib for CLL

Dr. Constantine Tam, a CLL specialist from the Alfred Hospital in Melbourne, Australia, recently discussed the ALPINE study's findings at the ASH 2023 conference. This study compared zanubrutinib (Brukinsa), a second-generation BTK inhibitor, to ibrutinib (Imbruvica), a first-generation BTK inhibitor, for treating relapsed/refractory CLL. Dr. Tam's insights are important for CLL patients as they provide guidance on selecting the most effective treatment for their condition. We invite you to watch his interview or read the summary of it below.

Background: Ibrutinib and Zanubrutinib in Treating CLL

Ibrutinib has long been a go-to treatment for relapsed/refractory CLL, known for its effectiveness in limiting disease progression for multiple years. However, it often causes side effects, notably atrial fibrillation. This heart condition, marked by an irregular and fast heartbeat, leads to symptoms such as heart flutter, tiredness, and breathlessness. It can cause serious issues like stroke or heart failure, which are dangerous if not treated. 

Zanubrutinib, a newer BTK inhibitor, was created to minimize these side effects while aiming to match or surpass ibrutinib's ability to control CLL. 

Key Findings from the ALPINE Study 

The ALPINE study is important as it directly compares ibrutinib and zanubrutinib. Results show that zanubrutinib has significantly fewer heart-related side effects, particularly atrial fibrillation, compared to ibrutinib. 6.2% of patients taking zanubrutinib experienced atrial fibrillation compared to 16.0% of patients taking ibrutinib. 

Earlier data showed zanubrutinib to be more effective than ibrutinib in limiting the progression of CLL, a finding that was first met with skepticism because no prior study had found one BTK inhibitor to be better than another at limiting the progression of the disease. 

The 2023 update of the ALPINE study, with another year of data, reinforces these findings. It confirms that zanubrutinib is safer than ibrutinib regarding heart side effects and more effective in limiting the progression of CLL. After three years, 65.8% of patients on zanubrutinib showed that the medicine continued to limit the progression of their CLL compared to 54.3% of patients on ibrutinib. 

Why This Matters for CLL Patients

These results are important for CLL patients to understand because they indicate a shift in treatment options. Newer medicines like zanubrutinib may become preferred for their effectiveness and safety. This information helps patients and healthcare providers in making informed treatment decisions, balancing effectiveness against quality of life impacted by side effects. 

In conclusion, the extended results from the ALPINE study show that zanubrutinib is safer than ibrutinib and more effective in controlling CLL. This progress marks a significant improvement in CLL treatment, offering hope for better patient outcomes and quality of life. 

Interested in Accelerating Research? Join HealthTree Cure Hub!

Are you interested in accelerating research toward a cure for CLL? We have created a powerful patient data portal named HealthTree Cure Hub for this very purpose. We invite you to join the 12,000-and-counting blood cancer patients who are collaborating with specialists through research surveys and studies in HealthTree Cure Hub. YOU are the key to improving CLL care. We are grateful for your time and support in helping us progress toward a CLL cure. Create your free HealthTree Cure Hub account by visiting the link below!

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