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Dr Mazyar Shadman: Zanubrutinib Significantly Improves HRQOL in Patients With CLL/SLL in the SEQUOIA Trial


Mazyar Shadman, MD, MPH, of Fred Hutchinson Cancer Research Center and University of Washington, discussed positive health-related quality of life (HRQOL) findings of the SEQUOIA trial investigating zanubrutinib vs bendamustine/rituximab in the treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL).

Zanubrutinib was associated with significant improvement in patient-reported outcomes of health-related quality of life (HRQOL) vs bendamustine/rituximab (BR) for the treatment of chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) at 12 and 24 weeks in the SEQUOIA trial, said Mazyar Shadman, MD, MPH, associate professor of medical oncology at Fred Hutchinson Cancer Research Center, and assistant professor of medicine at University of Washington.

Shadman served as co-author of a study presented at the 2022 European Hematology Association (EHA) Congress, titled, "Patient-reported outcomes from a phase 3 randomized study of zanubrutinib versus bendamustine plus rituximab in patients with treatment-naive CLL/SLL."


What specific data trends were noteworthy regarding zanubrutinib in the SEQUOIA study presented at EHA2022?

The SEQUOIA study was a randomized phase 3 head-to-head trial comparing zanubrutinib as monotherapy to bendamustine/rituximab, and the study did meet the primary end point of progression-free survival (PFS) benefit in favor of zanubrutinib. In this specific analysis, we looked at health quality measures, comparing the monotherapy, nonchemotherapy treatment zanubrutinib to bendamustine/rituximab, and tried to look at patient-reported outcomes in regards to some of the standard measurements of health quality measures in both arms.

Can you discuss the HRQOL findings observed with zanubrutinib vs BR at weeks 12 an 24 of the SEQUOIA trial?

So, when we have that conversation with the patient, between the physician and the patient, and we talk about the clinical efficacy, we talk about the side effects, and now we have this third aspect of data that we can present to the patient in terms of health-related quality of life measures that we looked at.

In this study, we looked at 12 weeks and 24 weeks as the cutoff and the patient-reported outcomes, they reported their improvement in specific measures compared with baseline. And we looked at things like physical role in fitness, we looked at symptoms like fatigue, diarrhea, nausea, vomiting, and pain.

What we found in this study was that when we looked at week 12 and also week 24, in terms of quality of life and the standard measures that patients reported, we had more significant improvement compared with baseline in patients who received zanubrutinib vs chemotherapy with bendamustine/rituximab.

For example, patients reported that their physical fitness and physical role was improved compared to baseline in zanubrutinib compared to bendamustine/rituximab. We also looked specifically at some symptoms, and for example, nausea, vomiting, fatigue, and diarrhea were significantly improved in patients who received zanubrutinib vs bendamustine/rituximab, both at 12 and 24 [weeks].

So, as a physician, when we try to approach a patient, not only we talk about the efficacy and now knowing the superior efficacy of zanubrutinib, we talk about the side effect profile, and we're now able to counsel the patient and talk to them about the improvement that we're seeing in terms of what patients actually reported on a clinical trial comparing the 2 arms.

So, there are clinical implications of this data, and really, they add to the quality of the conversation that a physician and a patient have before selecting any specific therapy, in this case zanubrutinib.

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