Evaluating Complete Response/Remission Rate as a Surrogate Endpoint in Relapsed/Refractory Chronic Lymphocytic Leukemia
Researchers at Bristol-Myers Squibb Company and other institutions have identified complete response/remission (CR) rate as a potential surrogate endpoint in patients with relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL). The study, published in Leukemia Research, analyzed data from 20 randomized controlled trials (RCTs) involving 5,765 patients with R/R CLL/SLL. The research found that higher CR rates were associated with statistically significant lower hazards of disease progression/death, with each 10% increase in CR rate linked to a 26% (95% CI, 22-30%) reduction in risk of progression/death.
Key Takeaways:
- The study evaluated CR rate as a surrogate endpoint for progression-free survival (PFS) in patients with R/R CLL/SLL using data from 20 RCTs.
- Across RCTs, higher CR rates resulted in statistically significant lower hazards of disease progression/death.
- The association between CR rate and PFS benefits was demonstrated using weighted linear models, Daniels and Hughes models, and Riley bivariate random-effects meta-analysis.
- Twenty RCTs were identified, investigating various treatments, including Bruton tyrosine kinase inhibitors, a B-cell lymphoma 2 inhibitor, phosphatidylinositol 3-kinase inhibitors, chimeric antigen receptor T-cell therapy, anti-CD20 monoclonal antibody, and chemotherapy.
- The study's results were broadly consistent across different models, including nonparametric (Cox) and parametric (exponential, Weibull, Gompertz) proportional hazards models.
- Cross-validation analyses demonstrated that treatment effects on CR rate reasonably predicted PFS benefits.
- The study concluded that CR rate is an essential treatment goal and a valid surrogate endpoint in R/R CLL/SLL.
Statistics:
- 20 RCTs were identified, involving 5,765 patients with R/R CLL/SLL.
- Across RCTs, each 10% increase in CR rate was associated with a 26% (95% CI, 22-30%) reduction in risk of progression/death.
- The association between CR rate and PFS benefits was demonstrated using weighted linear models, Daniels and Hughes models, and Riley bivariate random-effects meta-analysis.
- Twenty RCTs were identified, investigating various treatments, including Bruton tyrosine kinase inhibitors, a B-cell lymphoma 2 inhibitor, phosphatidylinositol 3-kinase inhibitors, chimeric antigen receptor T-cell therapy, anti-CD20 monoclonal antibody, and chemotherapy.
Sources:
- Evaluating complete response/remission rate as a surrogate endpoint in relapsed/refractory chronic lymphocytic leukemia. Leukemia Research, 2025;158:108113.
- Pergamon-elsevier Science Ltd, The Boulevard, Langford Lane, Kidlington, Oxford OX5 1GB, England.
- Bristol-Myers Squibb Company, Princeton, NJ, United States.
- Murat Kurt, Lin Wang, Tim Disher, Fei Fei Liu, Samantha Craigie, Serena K. Perna, Elise Aronitz, Toby A. Eyre, Loic Ysebaert, and Matthew S. Davids.