30 Despite an OS advantage observed in the phase 3 trial by addition of idelalisib to chemoimmunotherapy with bendamustine with rituximab for r/r CLL, outcomes of the randomized UNITY trial showed a trend toward worse OS with U2 when compared with the control arm or chlorambucil with obinutuzumab, suggesting that prolonged administration was unsafe in the COVID-19 era. 31 , 32 Immune-mediated side effects have been well described with PI3K inhibitors. 33 , 34 The concern for excessive infectious complications was recognized in 2016 when 6 randomized studies with idelalisib were halted after a decrease in OS was identified.
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Response-adapted, time-limited venetoclax, umbralisib, and ublituximab for relapsed/refractory chronic lymphocytic leukemia.
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