Venetoclax-Ibrutinib Combinations as First-Line Therapy in Chronic Lymphocytic Leukemia: A Meta-Analysis of Randomized Controlled Trials with GRADE Approach

INTRODUCTIONChronic lymphocytic leukemia (CLL) is the most common adult leukemia in Western countries, characterized by the accumulation of mature clonal B cells in the peripheral blood (PB), bone marrow, and lymphoid tissues.Although the disease course is heterogeneous, many patients eventually require therapy, and historically, chemoimmunotherapy with fludarabine, cyclophosphamide, and rituximab or bendamustine-based regimens represented standard first-line approaches. 1 CLL treatment has shifted from chemoimmunotherapy to targeted agents that disrupt key pathogenic pathways.2 Among these, the Bruton's tyrosine kinase inhibitor ibrutinib and the B-cell lymphoma-2 (BCL-2) inhibitor venetoclax have each demonstrated durable remissions as monotherapy in CLL.The combination of ibrutinib and venetoclax is supported by a Cite this article as: Tanrıverdi LH, Sarıcı A. Venetoclax-ibrutinib combinations as first-line therapy in chronic lymphocytic leukemia: a metaanalysis of randomized controlled trials with GRADE approach.