Lymphocytic Leukemia, Chronic
Conditions
Brief summary
This open-label, randomized, 3-arm study will evaluate the efficacy and safety of obinutuzumab (RO5072759) in combination with chlorambucil as compared to rituximab plus chlorambucil or chlorambucil alone in patients with previously untreated chronic lymphocytic leukemia (CLL). Patients will be randomized 2:2:1 to receive a maximum of six 28-day cycles of either RO5072759 (1000 mg intravenous (iv) infusion, on days 1, 8 and 15 of cycle 1 and day 1 of cycles 2-6) plus chlorambucil (0.5 mg/kg orally, days 1 and 15 of cycles 1-6), or rituximab (iv infusion day 1, 375 mg/m\^2 cycle 1, 500 mg/m\^2 cycles 2-6) plus chlorambucil, or chlorambucil alone. Anticipated time on study treatment is \>6 months and follow-up for disease-progression and safety will be at least 5 years. In the US, this trial is sponsored/managed by Genentech.
Detailed description
Protocol BO21004 is divided into 3 separate Unique Protocol IDs for reporting results on clinicaltrials.gov because there are 3 separate primary analyses conducted at different time-points. * BO21004 (Stage 1a) \[NCT01010061\] includes the analysis of 2 of the 3 arms obinutuzumab plus chlorambucil (Glb) compared to chlorambucil (Clb) reported here. * BO21004 (Stage 1b) \[NCT01998880\] includes the analysis of 2 of the 3 arms rituximab plus chlorambucil (RClb) compared to chlorambucil (Clb) reported separately. * BO21004 (Stage 2) \[NCT02053610\] includes the analysis of 2 of the 3 arms obinutuzumab plus chlorambucil (Glb) compared to rituximab plus chlorambucil (RClb) reported separately.
Interventions
1000 mg obinutuzumab intravenous (IV) infusion, on Days 1 \[first infusion split 100 mg on Day 1 and 900 mg on Day 2 as per protocol amendment\], 8 and 15 in Cycle 1 and Day 1 in Cycles 2-6 (28-day cycles).
375 mg/m\^2 rituximab intravenous (IV) infusion on Day 1 of Cycle 1 (Cycle duration is 28 days) then 500 mg/m\^2 IV infusions on Day 1 of Cycles 2-6.
Chlorambucil 0.5 mg/kg orally on Day 1 and 15 of each 28-day cycle.
Sponsors
Study design
Eligibility
Inclusion criteria
* Adults \>/=18 years * Documented Cluster of Differentiation Antigen 20 (CD20) + B-Cell Chronic Lymphocytic Lymphoma (B-CLL) * Previously untreated Chronic Lymphocytic Leukemia (CLL) requiring treatment according to the National Cancer Institute (NCI) criteria * Total Cumulative Illness Rating Scale (CIRS) \> 6 and/or creatinine clearance \< 70 ml/min
Exclusion criteria
* Prior CLL therapy * Transformation of CLL to aggressive Non-Hodgkin's Lymphoma (NHL) (Richter's transformation) * History of other malignancy unless the malignancy has been in remission without treatment for \>/=2 years prior to enrolment, and except for carcinoma in situ of the cervix, basal or squamous cell skin cancer, surgically treated low-grade prostate cancer, or ductal carcinoma in situ (DCIS) of the breast treated with lymphectomy alone * Positive hepatitis serology (HBV, HCV) or positive HIV or Human T Cell Leukemia Virus (HTLV) testing * Patients with active infection requiring systemic treatment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Progression-free Survival (PFS) | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | PFS was defined as the time from randomization to the first occurrence of progression, relapse, or death from any cause as assessed by the investigator. Progressive disease (PD) required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L). |
| Percentage of Participants With Progression Free Survival Events | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Percentage of Participants with Progression Free Survival Events: disease progression, relapse, or death. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Percentage of Participants With End of Treatment Response (EOTR) | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | EOTR was the first response assessment 56 days from the last dose according to the International Workshop on Chronic Lymphocytic Leukaemia (IWCLL) guidelines. CR required: Peripheral blood lymphocytes below 4 x 10\^9/L, Absence of significant lymphadenopathy, No hepatomegaly, No splenomegaly, Absence of disease, Blood counts above the following values (Neutrophils \>1.5 x 10\^9/L, Platelets \>100 x 10\^9/L, Hemoglobin \>11g/dL) and Bone marrow at least normocellular for age. CRi was CR with incomplete bone marrow recovery. PR required the following for at least 2 months from end of treatment: ≥50% decrease in peripheral blood lymphocyte count from the pre-treatment value AND Either a ≥ 50% reduction in lymphadenopathy OR ≥50% reduction of liver enlargement OR ≥50% reduction of spleen enlargement PLUS at least one of the following: Neutrophils \>1.5 x 10\^9/ or ≥50% increase, Platelets \>100 x 10\^9/L or ≥50% increase, Hemoglobin 11 g/dL or ≥50% increase. |
| Percentage of Participants With Best Overall Response | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Best overall response according to IWCLL guidelines was defined as the percentage of patients with CR, CRi,PR or nPR. CR required all of the following: Peripheral blood lymphocytes below 4 x 10\^9/L, Absence of significant lymphadenopathy, No hepatomegaly, No splenomegaly, Absence of disease, Blood counts above the following values (Neutrophils \>1.5 x 10\^9/L, Platelets \>100 x 10\^9/L, Hemoglobin \>11g/dL) and Bone marrow at least normocellular for age. CRi was CR with incomplete bone marrow recovery. PR required the following for at least 2 months from end of treatment: ≥50% decrease in peripheral blood lymphocyte count from the pre-treatment value AND Either a ≥ 50% reduction in lymphadenopathy OR ≥50% reduction of liver enlargement OR ≥50% reduction of spleen enlargement PLUS at least one of the following: Neutrophils \>1.5 x 10\^9/ or ≥50% increase, Platelets \>100 x 10\^9/L or ≥50% increase, Hemoglobin 11 g/dL or ≥50% increase. |
| Event Free Survival | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Event-free survival (EFS) was defined as the time between date of randomization and the date of disease progression/relapse, death, or start of a new anti-leukemic therapy. Progressive disease as per IWCLL criteria required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L). |
| Overall Survival | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Overall Survival (OS) was defined as the time between the date of randomization and the date of death due to any cause. |
| Duration of Response | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Duration of Response was defined as the date the response \[either Complete Response (CR) or Partial Response (PR)\] was first recorded until the date of Disease Progression or death due to any cause. Response was assessed according IWCLL guidelines. |
| Progression Free Survival Based on Independent Review Committee (IRC) Data | Randomization to clinical cutoff date of 9 May 2013 (median observation 22.8 months) | PFS was defined as the time from randomization to the first occurrence of progression, relapse, or death from any cause as assessed by Independent Review Committee. Progressive disease required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L). |
| Time to Re-Treatment/New-antileukemic Therapy | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Time to re-treatment/new anti-leukemic therapy was defined as time between the date of randomization and the date of first intake of re-treatment or new anti-leukemic therapy. |
| Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre- and post-dose sampling on day 1 of cycles 1-6 (Up to 26.8 months) | Blood samples were collected from all patients allocated to the GClb treatment arm pre- and post-dose Day 1 of Cycles 1 to 6 and were sent to a laboratory. The concentration of obinutzumab in serum was determined using a validated enzyme-linked immunosorbent assay (ELISA) and was reported in micrograms/milliliter (μg/mL). |
| European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Baseline and Cycle 4 Day 1 (Cy4D1) | The EORTC Quality of Life Questionnaire QLQ-C30 was used to assess patient-reported outcomes (PRO) and symptom burden. The QLQ-C30 contains 30 items including the functional scales of physical functioning (5 items), role functioning (2 items), emotional functioning (4 items), cognitive functioning (2 items), social functioning (2 items) and symptom scales including fatigue (3 items), nausea and vomiting (2 items), and pain (4 items) and six single item scales on dyspnea, sleep disturbance, appetite loss, constipation, diarrhea and financial impact. Final scores are transformed such that they range from 0 - 100, whereby higher scores indicate greater functioning, greater quality of life, or a greater degree of symptoms, with changes of 5 - 10 points considered to be of minimally important difference to participants. A positive change from Baseline indicated improvement. |
| European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Baseline and Cycle 4 Day 1 (Cy4D1) | EORTC Quality of Life Questionnaire (QLQ-CLL16) module was used to assess patient-reported outcomes and symptom burden. The QLQ-CLL16 module includes three multi-item scales assessing fatigue (2 items), treatment side effects and disease symptoms (8 items), infection (4 items) and two single item scales on social activities and future health worries. Final scores are transformed such that they range from 0 - 100, whereby higher scores indicate greater functioning, greater quality of life, or a greater degree of symptoms, with changes of 5 - 10 points considered to be of minimally important difference to participants. A positive change from Baseline indicated improvement. |
| Percentage of Participants With Molecular Remission at the End of Treatment | Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization) | Molecular remission was defined as a minimal residual disease (MRD)-negative result at the end of treatment (assessment that occurred between 56 days and 6 months of last treatment). Molecular remission was assessed for all patients using a blood sample. Additionally, a bone marrow sample was obtained from patients whom the investigator assumed to have a complete response, consistent with the IWCLL guidelines. A combined analysis of blood and bone marrow results was conducted. A patient was considered MRD negative if result was less than 1 chronic lymphocytic leukemia (CLL) cell in 10000 leukocytes (MRD value \< 0.0001) based on the method of allele specific polymerase chain reaction (ASO-PCR). |
| Percentage of Participants With Progression Free Survival Events Based on Independent Review Committee (IRC) Data | Randomization to clinical cutoff date of 9 May 2013 (median observation 22.8 months) | Percentage of Participants with Progression Free Survival Events: progression, relapse, or death from any cause as assessed by an Independent Review Committee. |
Countries
Argentina, Australia, Austria, Brazil, Bulgaria, Canada, Croatia, Czechia, Denmark, Egypt, Estonia, France, Germany, Hong Kong, Italy, Mexico, Netherlands, New Zealand, Romania, Russia, Slovakia, Spain, Switzerland, Thailand, United Kingdom, United States
Participant flow
Recruitment details
787 patients were enrolled in the study. Following a 6 patient safety run-in prior to randomization, 781 patients were randomized.
Pre-assignment details
589 patients were randomized to 1 of 3 treatment groups in 2:2:1 ratio: GClb (n=238), RClb (n=233) or Clb (n=118) in Stage 1 and an additional 192 randomized to GClb or RClb in Stage 2 \[NCT02053610\]. Stage 1 was divided for analysis into: Stage 1a (GClb vs Clb) n=356 reported here and Stage 1b (RClb vs Clb) \[NCT01998880\] reported separately.
Participants by arm
| Arm | Count |
|---|---|
| Obinutuzumab + Chlorambucil (GClb) Participants received 1000 mg obinutuzumab intravenous (IV) infusion, on Days 1 \[First infusion split 100 mg on Day 1 and 900 mg on Day 2 as per protocol amendment\], 8 and 15 in Cycle 1 and Day 1 in Cycles 2-6 (28-day cycles) plus chlorambucil 0.5 mg/kg orally on Day 1 and 15 of each 28-day cycle (6 Cycles). | 238 |
| Chlorambucil (Clb) Participants received chlorambucil 0.5 mg/kg orally on Day 1 and 15 of each 28-day cycle (6 Cycles). Participants with Progressive Disease or within 6 months of follow-up were allowed to cross over to receive obinutuzumab + chlorambucil. | 118 |
| Total | 356 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Administrative/Other | 0 | 1 |
| Overall Study | Adverse Events or Intercurrent Illness | 33 | 16 |
| Overall Study | Death | 3 | 6 |
| Overall Study | Did Not Receive Treatment | 2 | 2 |
| Overall Study | Disease Progression | 2 | 8 |
| Overall Study | Insufficient Therapeutic Response | 1 | 5 |
| Overall Study | Refused Treatment/Did Not Cooperate | 2 | 0 |
| Overall Study | Violation of Selection Criteria | 0 | 1 |
| Overall Study | Withdrew Consent | 5 | 1 |
Baseline characteristics
| Characteristic | Obinutuzumab + Chlorambucil (GClb) | Chlorambucil (Clb) | Total |
|---|---|---|---|
| Age, Customized <65 years | 42 participants | 26 participants | 68 participants |
| Age, Customized >=65 years | 196 participants | 92 participants | 288 participants |
| Sex: Female, Male Female | 98 Participants | 43 Participants | 141 Participants |
| Sex: Female, Male Male | 140 Participants | 75 Participants | 215 Participants |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk | EG002 affected / at risk |
|---|---|---|---|
| deaths Total, all-cause mortality | — / — | — / — | — / — |
| other Total, other adverse events | 215 / 241 | 89 / 116 | 23 / 30 |
| serious Total, serious adverse events | 113 / 241 | 45 / 116 | 8 / 30 |
Outcome results
Percentage of Participants With Progression Free Survival Events
Percentage of Participants with Progression Free Survival Events: disease progression, relapse, or death.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Intent-to-treat population included all randomized participants.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Progression Free Survival Events | 72.7 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Progression Free Survival Events | 90.7 Percentage of participants |
Progression-free Survival (PFS)
PFS was defined as the time from randomization to the first occurrence of progression, relapse, or death from any cause as assessed by the investigator. Progressive disease (PD) required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L).
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Intent-to-treat population included all randomized participants. Patients without PFS events were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Progression-free Survival (PFS) | 31.1 Months |
| Chlorambucil (Clb) | Progression-free Survival (PFS) | 11.1 Months |
Duration of Response
Duration of Response was defined as the date the response \[either Complete Response (CR) or Partial Response (PR)\] was first recorded until the date of Disease Progression or death due to any cause. Response was assessed according IWCLL guidelines.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Participants from the Intent-to-treat population (all randomized participants) with CR or PR. Participants without response were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Duration of Response | 24.8 Months |
| Chlorambucil (Clb) | Duration of Response | 5.1 Months |
European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score
The EORTC Quality of Life Questionnaire QLQ-C30 was used to assess patient-reported outcomes (PRO) and symptom burden. The QLQ-C30 contains 30 items including the functional scales of physical functioning (5 items), role functioning (2 items), emotional functioning (4 items), cognitive functioning (2 items), social functioning (2 items) and symptom scales including fatigue (3 items), nausea and vomiting (2 items), and pain (4 items) and six single item scales on dyspnea, sleep disturbance, appetite loss, constipation, diarrhea and financial impact. Final scores are transformed such that they range from 0 - 100, whereby higher scores indicate greater functioning, greater quality of life, or a greater degree of symptoms, with changes of 5 - 10 points considered to be of minimally important difference to participants. A positive change from Baseline indicated improvement.
Time frame: Baseline and Cycle 4 Day 1 (Cy4D1)
Population: ITT population. Here, n signifies the number of participants who were evaluated for specified categories.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Physical Functioning Scale: Cy4D1(n=189,93) | 78.6 unit on a scale | Standard Deviation 18.71 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Global Health Status Scale: Cy4D1(n=189,93) | 66.7 unit on a scale | Standard Deviation 20.03 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Appetite Loss Scale: Baseline (n=226, 111) | 18.1 unit on a scale | Standard Deviation 28.46 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Appetite Loss Scale: Cy4D1 (n=189, 92) | 10.2 unit on a scale | Standard Deviation 21.77 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Cognitive Functioning Scale: Baseline (n=227, 111) | 80.6 unit on a scale | Standard Deviation 21.35 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Cognitive Functioning Scale:Cy4D1 (n=190,93) | 83.9 unit on a scale | Standard Deviation 20.31 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Constipation Scale: Baseline (n=225, 111) | 14.8 unit on a scale | Standard Deviation 23.94 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Constipation Scale: Cy4D1 (n=188, 93) | 15.1 unit on a scale | Standard Deviation 25.16 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Diarrhoea Scale: Baseline (n=226, 110) | 9.3 unit on a scale | Standard Deviation 20.05 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Diarrhoea Scale: Cy4D1 (n=189, 93) | 9.3 unit on a scale | Standard Deviation 19.47 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Dyspnoea Scale: Baseline (n=225, 109) | 27.1 unit on a scale | Standard Deviation 29.89 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Dyspnoea: Cy4D1 (n=189, 91) | 15.9 unit on a scale | Standard Deviation 23.71 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Emotional Functioning Scale: Baseline (n=226, 111) | 73.8 unit on a scale | Standard Deviation 23.45 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Emotional Functioning Scale: Cy4D1(n=190,93) | 82.5 unit on a scale | Standard Deviation 18.62 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Fatigue Scale: Baseline (n=226, 111) | 38 unit on a scale | Standard Deviation 25.72 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Fatigue Scale: Cy4D1(n=189, 93) | 29.2 unit on a scale | Standard Deviation 20.39 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Financial Difficulties Scale: Baseline (n=224,110) | 8.9 unit on a scale | Standard Deviation 20.69 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Financial Difficulty Scale: Cy4D1(n=189,93) | 7.4 unit on a scale | Standard Deviation 17.64 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Nausea, Vomiting Scale: Baseline (n=227, 111) | 5 unit on a scale | Standard Deviation 11.18 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Nausea, Vomiting Scale: Cy4D1 (n=189,93) | 5.5 unit on a scale | Standard Deviation 11.51 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Pain scale: Baseline (n=228, 111) | 22.9 unit on a scale | Standard Deviation 27.57 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Pain scale: Cy4D1 (n=190, 93) | 17.9 unit on a scale | Standard Deviation 24.09 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Physical Functioning Scale: Baseline (n=228, 111) | 73.7 unit on a scale | Standard Deviation 19.86 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Global Health Status Scale: Baseline (n=226, 111) | 58.4 unit on a scale | Standard Deviation 22.8 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Role Functioning Scale: Baseline(n=227,110) | 76.1 unit on a scale | Standard Deviation 26.18 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Role Functioning Scale: Cy4D1(n=189,93) | 79.7 unit on a scale | Standard Deviation 23.64 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Social Functioning Scale:Baseline(n=226,110) | 86.3 unit on a scale | Standard Deviation 22.52 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Social Functioning Scale: Cy4D1(n=190,93) | 87.8 unit on a scale | Standard Deviation 19.97 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Insomnia Scale: Baseline (n=228,111) | 29.4 unit on a scale | Standard Deviation 31.12 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Insomnia Scale: Cy4D1(n=189,93) | 20.6 unit on a scale | Standard Deviation 27.13 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Cognitive Functioning Scale: Baseline (n=227, 111) | 81.8 unit on a scale | Standard Deviation 22.76 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Financial Difficulty Scale: Cy4D1(n=189,93) | 9.3 unit on a scale | Standard Deviation 19.88 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Fatigue Scale: Cy4D1(n=189, 93) | 30.8 unit on a scale | Standard Deviation 23 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Global Health Status Scale: Cy4D1(n=189,93) | 63.4 unit on a scale | Standard Deviation 20.56 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Role Functioning Scale: Cy4D1(n=189,93) | 81.5 unit on a scale | Standard Deviation 21.35 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Physical Functioning Scale: Cy4D1(n=189,93) | 80.9 unit on a scale | Standard Deviation 16.24 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Appetite Loss Scale: Baseline (n=226, 111) | 19.8 unit on a scale | Standard Deviation 29.26 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Financial Difficulties Scale: Baseline (n=224,110) | 13.6 unit on a scale | Standard Deviation 25.26 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Appetite Loss Scale: Cy4D1 (n=189, 92) | 14.5 unit on a scale | Standard Deviation 24.36 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Social Functioning Scale:Baseline(n=226,110) | 83.3 unit on a scale | Standard Deviation 25.34 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Global Health Status Scale: Baseline (n=226, 111) | 57.4 unit on a scale | Standard Deviation 22.9 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Cognitive Functioning Scale:Cy4D1 (n=190,93) | 85.8 unit on a scale | Standard Deviation 18.54 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Nausea, Vomiting Scale: Baseline (n=227, 111) | 7.4 unit on a scale | Standard Deviation 18.49 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Constipation Scale: Baseline (n=225, 111) | 16.8 unit on a scale | Standard Deviation 26.92 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Insomnia Scale: Baseline (n=228,111) | 31.5 unit on a scale | Standard Deviation 32.98 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Constipation Scale: Cy4D1 (n=188, 93) | 12.5 unit on a scale | Standard Deviation 23.53 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Nausea, Vomiting Scale: Cy4D1 (n=189,93) | 7.5 unit on a scale | Standard Deviation 17.81 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Diarrhoea Scale: Baseline (n=226, 110) | 8.8 unit on a scale | Standard Deviation 18.98 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Role Functioning Scale: Baseline(n=227,110) | 74.7 unit on a scale | Standard Deviation 28.35 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Diarrhoea Scale: Cy4D1 (n=189, 93) | 6.5 unit on a scale | Standard Deviation 14.95 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Pain scale: Baseline (n=228, 111) | 21.5 unit on a scale | Standard Deviation 25.66 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Dyspnoea Scale: Baseline (n=225, 109) | 23.9 unit on a scale | Standard Deviation 27.63 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Social Functioning Scale: Cy4D1(n=190,93) | 85.5 unit on a scale | Standard Deviation 19.38 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Dyspnoea: Cy4D1 (n=189, 91) | 22.3 unit on a scale | Standard Deviation 26.78 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Pain scale: Cy4D1 (n=190, 93) | 17.7 unit on a scale | Standard Deviation 25.98 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Emotional Functioning Scale: Baseline (n=226, 111) | 72.9 unit on a scale | Standard Deviation 25.7 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Insomnia Scale: Cy4D1(n=189,93) | 24.4 unit on a scale | Standard Deviation 29.13 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Emotional Functioning Scale: Cy4D1(n=190,93) | 80.6 unit on a scale | Standard Deviation 18.48 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Physical Functioning Scale: Baseline (n=228, 111) | 77.3 unit on a scale | Standard Deviation 18.87 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 Questionnaire Score | Fatigue Scale: Baseline (n=226, 111) | 36.9 unit on a scale | Standard Deviation 27.01 |
European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score
EORTC Quality of Life Questionnaire (QLQ-CLL16) module was used to assess patient-reported outcomes and symptom burden. The QLQ-CLL16 module includes three multi-item scales assessing fatigue (2 items), treatment side effects and disease symptoms (8 items), infection (4 items) and two single item scales on social activities and future health worries. Final scores are transformed such that they range from 0 - 100, whereby higher scores indicate greater functioning, greater quality of life, or a greater degree of symptoms, with changes of 5 - 10 points considered to be of minimally important difference to participants. A positive change from Baseline indicated improvement.
Time frame: Baseline and Cycle 4 Day 1 (Cy4D1)
Population: ITT population. Here, n signifies the number of participants who were evaluated for specified categories.
| Arm | Measure | Group | Value (MEAN) | Dispersion |
|---|---|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Disease Effects Scale: Baseline (n=209, 102) | 23 unit on a scale | Standard Deviation 18.89 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Disease Effects Scale: Cy4D1 (n=176, 86) | 15.0 unit on a scale | Standard Deviation 15.12 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Fatigue Scale: Baseline (n=209, 102) | 31.2 unit on a scale | Standard Deviation 25.83 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Fatigue Scale: Cy4D1 (n=176, 86) | 20.9 unit on a scale | Standard Deviation 21.51 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Future Health: Baseline (n=206, 101) | 47.7 unit on a scale | Standard Deviation 32.14 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Future Health: Cy4D1 (n=175, 86) | 29.5 unit on a scale | Standard Deviation 31.74 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Infection Scale: Baseline (n=209, 102) | 12 unit on a scale | Standard Deviation 15.91 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Infection Scale: Cy4D1 (n=176, 86) | 8.9 unit on a scale | Standard Deviation 11.65 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Social Problems: Baseline (n=206, 100) | 24.3 unit on a scale | Standard Deviation 31.99 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Social Problems: Cy4D1 (n=175, 85) | 19.4 unit on a scale | Standard Deviation 27.75 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Treatment Side Effects Scale: Baseline (n=209,102) | 19.8 unit on a scale | Standard Deviation 17.7 |
| Obinutuzumab + Chlorambucil (GClb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Treatment Side Effect Scale: Cy4D1(n=176,86) | 14.7 unit on a scale | Standard Deviation 14.68 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Treatment Side Effects Scale: Baseline (n=209,102) | 17.2 unit on a scale | Standard Deviation 15.27 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Disease Effects Scale: Baseline (n=209, 102) | 23.7 unit on a scale | Standard Deviation 20.18 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Infection Scale: Baseline (n=209, 102) | 14.6 unit on a scale | Standard Deviation 17.97 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Disease Effects Scale: Cy4D1 (n=176, 86) | 15.9 unit on a scale | Standard Deviation 14.16 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Social Problems: Cy4D1 (n=175, 85) | 22.0 unit on a scale | Standard Deviation 27 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Fatigue Scale: Baseline (n=209, 102) | 27.6 unit on a scale | Standard Deviation 24.65 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Infection Scale: Cy4D1 (n=176, 86) | 8.5 unit on a scale | Standard Deviation 10.7 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Fatigue Scale: Cy4D1 (n=176, 86) | 23.4 unit on a scale | Standard Deviation 22.2 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Treatment Side Effect Scale: Cy4D1(n=176,86) | 15.6 unit on a scale | Standard Deviation 16.11 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Future Health: Baseline (n=206, 101) | 50.8 unit on a scale | Standard Deviation 33.53 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Social Problems: Baseline (n=206, 100) | 26.3 unit on a scale | Standard Deviation 33.26 |
| Chlorambucil (Clb) | European Organization for Research and Treatment of Cancer (EORTC) QLQ-CLL16 Questionnaire Score | Future Health: Cy4D1 (n=175, 86) | 39.1 unit on a scale | Standard Deviation 30.33 |
Event Free Survival
Event-free survival (EFS) was defined as the time between date of randomization and the date of disease progression/relapse, death, or start of a new anti-leukemic therapy. Progressive disease as per IWCLL criteria required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L).
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Intent-to-treat population included all randomized participants. Patients without EFS events were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Event Free Survival | 28.7 Months |
| Chlorambucil (Clb) | Event Free Survival | 10.8 Months |
Overall Survival
Overall Survival (OS) was defined as the time between the date of randomization and the date of death due to any cause.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Intent-to-treat population included all randomized participants. Patients without OS events were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Overall Survival | NA Months |
| Chlorambucil (Clb) | Overall Survival | 66.7 Months |
Percentage of Participants With Best Overall Response
Best overall response according to IWCLL guidelines was defined as the percentage of patients with CR, CRi,PR or nPR. CR required all of the following: Peripheral blood lymphocytes below 4 x 10\^9/L, Absence of significant lymphadenopathy, No hepatomegaly, No splenomegaly, Absence of disease, Blood counts above the following values (Neutrophils \>1.5 x 10\^9/L, Platelets \>100 x 10\^9/L, Hemoglobin \>11g/dL) and Bone marrow at least normocellular for age. CRi was CR with incomplete bone marrow recovery. PR required the following for at least 2 months from end of treatment: ≥50% decrease in peripheral blood lymphocyte count from the pre-treatment value AND Either a ≥ 50% reduction in lymphadenopathy OR ≥50% reduction of liver enlargement OR ≥50% reduction of spleen enlargement PLUS at least one of the following: Neutrophils \>1.5 x 10\^9/ or ≥50% increase, Platelets \>100 x 10\^9/L or ≥50% increase, Hemoglobin 11 g/dL or ≥50% increase.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Participants from the Intent-to-treat population (all randomized participants) with data available for analysis. Participants who did not reach the 3 month Follow-up visit at the time of the clinical cutoff are excluded.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | No Response Assessment | 13.4 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Progressive Disease | 4.2 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Complete Response (CR) | 26.5 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Complete Response incomplete (CRi) | 2.5 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Partial Response (PR) | 47.1 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Nodular Partial Response (nPR) | 2.1 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Best Overall Response | Stable Disease | 4.2 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | No Response Assessment | 16.9 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Progressive Disease | 28.8 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Partial Response (PR) | 31.4 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Stable Disease | 21.2 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Complete Response (CR) | 0.0 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Nodular Partial Response (nPR) | 0 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Best Overall Response | Complete Response incomplete (CRi) | 1.7 Percentage of participants |
Percentage of Participants With End of Treatment Response (EOTR)
EOTR was the first response assessment 56 days from the last dose according to the International Workshop on Chronic Lymphocytic Leukaemia (IWCLL) guidelines. CR required: Peripheral blood lymphocytes below 4 x 10\^9/L, Absence of significant lymphadenopathy, No hepatomegaly, No splenomegaly, Absence of disease, Blood counts above the following values (Neutrophils \>1.5 x 10\^9/L, Platelets \>100 x 10\^9/L, Hemoglobin \>11g/dL) and Bone marrow at least normocellular for age. CRi was CR with incomplete bone marrow recovery. PR required the following for at least 2 months from end of treatment: ≥50% decrease in peripheral blood lymphocyte count from the pre-treatment value AND Either a ≥ 50% reduction in lymphadenopathy OR ≥50% reduction of liver enlargement OR ≥50% reduction of spleen enlargement PLUS at least one of the following: Neutrophils \>1.5 x 10\^9/ or ≥50% increase, Platelets \>100 x 10\^9/L or ≥50% increase, Hemoglobin 11 g/dL or ≥50% increase.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Participants from the Intent-to-treat population (all randomized participants) with data available for analysis. Participants who did not reach the 3 month Follow-up visit at the time of the clinical cutoff are excluded.
| Arm | Measure | Group | Value (NUMBER) |
|---|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Stable Disease | 5 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Complete Response incomplete (CRi) | 4.2 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Nodular Partial Response (nPR) | 7.6 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Partial Response (PR) | 48.3 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Progressive Disease | 4.2 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | No Response Assessment | 13.4 Percentage of participants |
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With End of Treatment Response (EOTR) | Complete Response (CR) | 17.2 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | No Response Assessment | 16.9 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Complete Response (CR) | 0.0 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Complete Response incomplete (CRi) | 0.0 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Partial Response (PR) | 28.8 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Stable Disease | 22.9 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Progressive Disease | 28.8 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With End of Treatment Response (EOTR) | Nodular Partial Response (nPR) | 2.5 Percentage of participants |
Percentage of Participants With Molecular Remission at the End of Treatment
Molecular remission was defined as a minimal residual disease (MRD)-negative result at the end of treatment (assessment that occurred between 56 days and 6 months of last treatment). Molecular remission was assessed for all patients using a blood sample. Additionally, a bone marrow sample was obtained from patients whom the investigator assumed to have a complete response, consistent with the IWCLL guidelines. A combined analysis of blood and bone marrow results was conducted. A patient was considered MRD negative if result was less than 1 chronic lymphocytic leukemia (CLL) cell in 10000 leukocytes (MRD value \< 0.0001) based on the method of allele specific polymerase chain reaction (ASO-PCR).
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Participants from the Intent-to-treat population (all randomized participants) with data available for analysis. Participants who did not reach the 3 month Follow-up visit at the time of the clinical cutoff are excluded.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Molecular Remission at the End of Treatment | 25 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Molecular Remission at the End of Treatment | 0 Percentage of participants |
Percentage of Participants With Progression Free Survival Events Based on Independent Review Committee (IRC) Data
Percentage of Participants with Progression Free Survival Events: progression, relapse, or death from any cause as assessed by an Independent Review Committee.
Time frame: Randomization to clinical cutoff date of 9 May 2013 (median observation 22.8 months)
Population: Intent-to-treat population included all randomized participants. Participants without PFS events were censored.
| Arm | Measure | Value (NUMBER) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Percentage of Participants With Progression Free Survival Events Based on Independent Review Committee (IRC) Data | 37.4 Percentage of participants |
| Chlorambucil (Clb) | Percentage of Participants With Progression Free Survival Events Based on Independent Review Committee (IRC) Data | 76.3 Percentage of participants |
Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb)
Blood samples were collected from all patients allocated to the GClb treatment arm pre- and post-dose Day 1 of Cycles 1 to 6 and were sent to a laboratory. The concentration of obinutzumab in serum was determined using a validated enzyme-linked immunosorbent assay (ELISA) and was reported in micrograms/milliliter (μg/mL).
Time frame: Pre- and post-dose sampling on day 1 of cycles 1-6 (Up to 26.8 months)
Population: PK population includes all participants with PK data available at the given time-point.
| Arm | Measure | Group | Value (GEOMETRIC_MEAN) | Dispersion |
|---|---|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 1 (n=201) | 247 μg/mL | Geometric Coefficient of Variation 41.6 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre-dose Cycle 2 (n=198) | 227 μg/mL | Geometric Coefficient of Variation 57.9 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 2 (n=197) | 587 μg/mL | Geometric Coefficient of Variation 36.5 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre-dose Cycle 3 (n=193) | 165 μg/mL | Geometric Coefficient of Variation 68.7 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 3 (n=192) | 527 μg/mL | Geometric Coefficient of Variation 39.7 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre-dose Cycle 4 (n=191) | 156 μg/mL | Geometric Coefficient of Variation 74.3 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 4 (n=189) | 535 μg/mL | Geometric Coefficient of Variation 41 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre-dose Cycle 5 (n=185) | 163 μg/mL | Geometric Coefficient of Variation 72.4 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 5 (n=181) | 534 μg/mL | Geometric Coefficient of Variation 39.1 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Pre-dose Cycle 6 (n=185) | 181 μg/mL | Geometric Coefficient of Variation 69 |
| Obinutuzumab + Chlorambucil (GClb) | Pharmacokinetics of Obinutuzumab (RO5072759) in Combination With Chlorambucil (Clb) | Post-dose Cycle 6 (n=183) | 525 μg/mL | Geometric Coefficient of Variation 39.6 |
Progression Free Survival Based on Independent Review Committee (IRC) Data
PFS was defined as the time from randomization to the first occurrence of progression, relapse, or death from any cause as assessed by Independent Review Committee. Progressive disease required at least one of the following: ≥50% increase in the absolute number of lymphocytes, appearance of new palpable lymph nodes (\>15 mm in longest diameter) or any new extra nodal lesion, ≥50% increase in the longest diameter of any previous site of clinically significant lymphadenopathy, ≥50% increase in the enlargement of the liver and/or spleen, Transformation to a more aggressive histology or After treatment, the progression of any cytopenia (a decrease of hemoglobin levels \>20 g/L or \<10 g/dL or a decrease of platelet counts \>50% or \<100 x 10\^9/L or by a decrease of neutrophil counts \>50% or \<1.0 x 10\^9/L).
Time frame: Randomization to clinical cutoff date of 9 May 2013 (median observation 22.8 months)
Population: Intent-to-treat population included all randomized participants. Patients without PFS events were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Progression Free Survival Based on Independent Review Committee (IRC) Data | 27.2 Months |
| Chlorambucil (Clb) | Progression Free Survival Based on Independent Review Committee (IRC) Data | 11.2 Months |
Time to Re-Treatment/New-antileukemic Therapy
Time to re-treatment/new anti-leukemic therapy was defined as time between the date of randomization and the date of first intake of re-treatment or new anti-leukemic therapy.
Time frame: Randomization to clinical cutoff date of 10 Oct 2017 (median observation 62.5 months from randomization)
Population: Intent-to-treat population included all randomized participants. Participants without events (re-treatment or new anti-leukemic therapy) were censored.
| Arm | Measure | Value (MEDIAN) |
|---|---|---|
| Obinutuzumab + Chlorambucil (GClb) | Time to Re-Treatment/New-antileukemic Therapy | 55.7 Months |
| Chlorambucil (Clb) | Time to Re-Treatment/New-antileukemic Therapy | 15.1 Months |